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Individual

DR. ELAINE MARIE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
110 FORD ST, BOONVILLE, NY 13309-1204
(315) 942-9220
Mailing address
12334 POTATO HILL RD, BOONVILLE, NY 13309-4836
(315) 527-6469

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
029516
NY

Other

Enumeration date
08/31/2010
Last updated
08/31/2010
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