Individual
AMY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1890 CROOKS RD, SUITE 140, TROY, MI 48084-5506
(586) 871-5224
Mailing address
14761 BORGMAN ST, OAK PARK, MI 48237-1014
(586) 871-5224
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
476042
MI
Other
Enumeration date
09/03/2015
Last updated
07/28/2016
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