Individual
CHRISTINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 637-4385
Mailing address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 637-4385
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9859-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8149-26
STATE OF WISCONSIN
WI
Enumeration date
01/19/2023
Last updated
01/19/2023
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