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Individual

JEFFREY A MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
7455 W WASHINGTON AVE, SUITE 100, LAS VEGAS, NV 89128-4337
(702) 735-1875
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
130359
NV

Other

Enumeration date
10/01/2013
Last updated
07/22/2015
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