| NPI | 1548460363 |
|---|---|
| Former Name | HOLLY ANN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06501) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010634) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2016-05-13 |