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1174699011
CANDICE M. MOORE
JACKSON, MS
NPI
1174699011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MS OT1713)
Enumeration Date
2006-11-24
Last Update Date
2007-07-08
Business Address
-- CANDICE M. MOORE OTR L
4500 INTERSTATE 55 NORTH SUITE 291, HIGHLAND VILLAGE
JACKSON, MS 39211
Phone number: 601-362-0859
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Mailing Address
-- CANDICE M. MOORE OTR L
766 CLEARMONT DR
PEARL, MS 39208-6261
Phone number:
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