Individual
JAMIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 544-6464
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 544-6464
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009232
IL
Other
Enumeration date
12/13/2010
Last updated
02/09/2016
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