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Individual

JOYCE L MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC/PTA

Contact information

Practice address
11392 PLEASANT VALLEY RD, PENN VALLEY, CA 95946-9001
(530) 432-9660
Mailing address
13996 HIGHLAND DR, GRASS VALLEY, CA 95945-8719
(530) 205-8870

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3774
CA
2255A2300X
Athletic Trainer
000080967
CA

Other

Enumeration date
10/29/2017
Last updated
10/29/2017
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