Individual
SAMANTHA ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
103 N MAIN ST # 201, GREENVILLE, SC 29601-2796
(864) 528-5753
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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