Individual
AMANDA MARTIN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T., OT
Contact information
Practice address
3328 BEMISS RD, VALDOSTA, GA 31605-7014
(229) 244-1201
(229) 244-1207
Mailing address
3328 BEMISS RD, VALDOSTA, GA 31605-7014
(229) 244-1201
(229) 244-1207
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009863
GA
225X00000X
Occupational Therapist
OT005039
GA
Other
Enumeration date
06/04/2010
Last updated
01/24/2014
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