Individual
KAITLYN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6831 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 297-4564
Mailing address
4843 KELLY AVE, ROOTSTOWN, OH 44272-9286
(724) 714-9348
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA011221
OH
Other
Enumeration date
01/06/2016
Last updated
03/24/2021
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