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Individual

MR. NATHANAEL DAVID MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 275-0927
(336) 275-4834
Mailing address
2219 GRIFFITH DR, ORANGEBURG, SC 29118-4011
(412) 708-1153

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
009313
OH
225X00000X
Occupational Therapist
020010
NY
225X00000X
Occupational Therapist
OC014112
PA
225XH1200X
Hand Occupational Therapist
5674
SC
225XH1200X
Hand Occupational Therapist
Primary
9958
NC

Other

Enumeration date
10/22/2015
Last updated
12/12/2025
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