Individual
AMANDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600
Mailing address
3103 N UNIVERSITY AVE, DECATUR, IL 62526-1344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.022022
IL
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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