Individual
TERRY FRANCES MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1720 17TH ST, HUNTINGTON, WV 25701-4235
(304) 529-6031
Mailing address
1720 17TH ST, HUNTINGTON, WV 25701-4235
(304) 529-6031
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001067
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36121
—
WV
Enumeration date
09/10/2019
Last updated
09/10/2019
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