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Individual

LAKESHA MARION MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6735 W BRADLEY RD, MILWAUKEE, WI 53223-3325
(414) 362-0847
(414) 371-2390
Mailing address
S36W30435 SAINT DAVIDS DR, WAUKESHA, WI 53189-9287
(262) 470-7105

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2886-19
WI

Other

Enumeration date
04/10/2019
Last updated
04/10/2019
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