Individual
AMANDA DOLORES MOO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A., LMT
Contact information
Practice address
330 SW 165TH ST, NEWBERRY, FL 32669-3116
(352) 262-3978
Mailing address
330 SW 165TH ST, NEWBERRY, FL 32669-3116
(352) 262-3978
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA71374
FL
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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