Samantha Moore

NPI #1598197576 in Summit, Mississippi

Provider Information

NPI Number: 1598197576
Entity Type: Individual
Name: Samantha Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Aug 1, 2013
Last Updated: Mar 8, 2019

Practice Location

Address: 4109 HIGHWAY 98 W
City: Summit
State: Mississippi
ZIP Code: 39666-9132
Phone: (601) 276-3900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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