Individual
JESSIE LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
67 CRESCENT ST, PENNDEL, PA 19047-5203
(618) 944-2294
Mailing address
67 CRESCENT ST, PENNDEL, PA 19047-5203
(618) 944-2294
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30748
FL
Other
Enumeration date
09/28/2015
Last updated
01/18/2021
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