Individual
SHANDRA COLLEEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2365 PATRIOT HTS, COLORADO SPRINGS, CO 80904-5122
(719) 667-5360
Mailing address
920 EDGECLIFF DR, BEDFORD, TX 76022-7416
(817) 773-4703
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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