Individual
MR. CORY RYAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13501 N BRYANT AVE, EDMOND, OK 73013-6242
(405) 246-0222
Mailing address
12390 AUTUMN BRK, GUTHRIE, OK 73044-7593
(405) 308-3426
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
864
OK
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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