Individual
TAYLOR NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1500 GRAND CENTRAL AVE STE 108, VIENNA, WV 26105-1079
(304) 893-9586
Mailing address
1500 GRAND CENTRAL AVE STE 108, VIENNA, WV 26105-1079
(304) 893-9586
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2024-4101
WV
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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