Individual
JANAE LEIGH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
3409 MCFARLAND BLVD, NORTHPORT, AL 35476-3178
(205) 333-2220
(205) 333-2461
Mailing address
20548 OLD JASPER RD, NORTHPORT, AL 35475-1801
(205) 522-4144
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3099
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
OPTUM
AL
Enumeration date
03/30/2021
Last updated
03/30/2021
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