Individual
REBECCA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 COLLEGE AVE, OTTAWA, IL 61350-3858
(815) 434-1130
Mailing address
25749 S RED STABLE LN, CHANNAHON, IL 60410-8611
(630) 777-0448
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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