Individual
RYAN C MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11736 ROLLING PINE LN, PORT RICHEY, FL 34668-1150
(352) 445-6671
Mailing address
11736 ROLLING PINE LN, PORT RICHEY, FL 34668-1150
(352) 445-6671
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA14321
FL
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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