Individual
HAILEE RENAE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
951 HICKORY CREEK DR, TEMPERANCE, MI 48182-2327
(734) 206-8200
Mailing address
9150 ONSTED HWY, ONSTED, MI 49265-9707
(517) 902-3674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502006110
MI
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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