Individual
KELLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT, C-IAYT, CIYT
Contact information
Practice address
1776 S JACKSON ST STE 830, DENVER, CO 80210-3807
(720) 219-5622
Mailing address
1776 S JACKSON ST STE 830, DENVER, CO 80210-3807
(720) 219-5622
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-8091
CO
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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