Mary Melissa Moore P.T.

NPI 1639326184 - Physical Therapist - 225100000X

NPI Details
NPI 1639326184
Gender Female
Enumeration Date 08/26/2008
Last Updated 08/26/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
2500 NILES RD
SUITE 3
SAINT JOSEPH MI, 49085-3237, US
Phone (269) 428-1550
Fax (269) 428-6762
Business Location
11031 JONES RD
BERRIEN SPRINGS MI, 49103-9660, US
Phone (269) 684-7130
Fax
Toxanomy
Taxonomy Code 225100000X
License State Michigan
License Number 5501010163
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According to our database, Mrs. Mary Melissa Moore P.T. NPI is 1639326184, taxonomy code is 225100000X and license number is 5501010163, license state is located at Michigan. Mary Melissa Moore P.T. physically located at 2500 Niles Rd, Saint Joseph MI, 49085-3237. NPI Number Mary Melissa Moore P.T. has the Individual type.

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1639326184 NPI number is provided on an as is basis without warranty of any kind. 1639326184 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Melissa Moore P.T. are for informational purposes only.