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1942781299
KEVIN DOUGLAS MOON
KENMORE, NY
NPI
1942781299
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NY 022807)
Enumeration Date
2018-08-24
Last Update Date
2018-08-24
Business Address
Mr. KEVIN DOUGLAS MOON OTR/L
3767 DELAWARE AVE
KENMORE, NY 14217-1040
Phone number: 716-874-6175
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Mailing Address
Mr. KEVIN DOUGLAS MOON OTR/L
71 RAINTREE IS APT 3
TONAWANDA, NY 14150-2736
Phone number: 845-558-5871
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