Individual
CHERYL M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3226 WILKINS RD, ITHACA, NY 14850-9568
(607) 272-5891
Mailing address
49 CAROLINE DEPOT RD, BROOKTONDALE, NY 14817-9797
(607) 539-7442
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
004295-1
NY
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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