Individual
MRS. JANINE M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,MS,OCS,CERT MDT
Contact information
Practice address
75 SHELDON AVE SE STE 101, GRAND RAPIDS, MI 49503-4224
(616) 391-2420
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009567
MI
Other
Enumeration date
11/24/2006
Last updated
03/04/2022
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