Individual
MICHAEL R MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3850 E BASELINE RD STE 109, MESA, AZ 85206-4403
(480) 818-4212
Mailing address
3850 E BASELINE RD STE 109, MESA, AZ 85206-4403
(480) 818-4212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA046638
AZ
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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