Individual
LILY MAE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
350 79TH AVE N APT 210, ST PETERSBURG, FL 33702-4456
(586) 291-0309
Mailing address
350 79TH AVE N APT 210, ST PETERSBURG, FL 33702-4456
(586) 291-0309
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA94304
FL
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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