Individual
KELLYE MOORE-TEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1258 BELLEFONTAINE ST STE A, WAPAKONETA, OH 45895-9775
(419) 739-1980
(419) 739-1980
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(419) 739-1980
(419) 739-1982
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005913RX
OH
Other
Enumeration date
06/10/2019
Last updated
01/12/2021
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