Individual
MRS. LIZETTE DENISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01492
KS
Other
Enumeration date
07/03/2006
Last updated
07/16/2007
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