Individual
MARIA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
598 COUNTY ROAD 478, MILLERSVILLE, MO 63766-6261
(573) 243-7854
Mailing address
598 COUNTY ROAD 478, MILLERSVILLE, MO 63766-6261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1999135788
MO
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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