Individual
LAUREN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
84572 S 4660 RD, STILWELL, OK 74960-4876
(918) 316-6998
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6159
OK
Other
Enumeration date
06/09/2022
Last updated
11/06/2024
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