Individual
JAY A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-8050
Mailing address
612 LAKEVIEW AVE, WAKE FOREST, NC 27587-2990
(919) 434-6171
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3997
NC
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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