Individual
JENNIFER DIANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
501 CALDWELL LN, DUNBAR, WV 25064-2026
(304) 744-4761
Mailing address
2118 HIGHLAND AVE, SOUTH CHARLESTON, WV 25303-2035
(304) 543-6508
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003522
WV
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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