Individual
KRISTEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4927 LASHER CT, MURRYSVILLE, PA 15668-9318
(724) 994-8132
Mailing address
4927 LASHER CT, MURRYSVILLE, PA 15668-9318
(724) 994-8132
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30574324
DRIVER'S LICENSE
PA
Enumeration date
03/12/2019
Last updated
03/12/2019
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