Gina Marie Moore

NPI #1942771472 in Pocatello, Idaho

Provider Information

NPI Number: 1942771472
Entity Type: Individual
Name: Gina Marie Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Dec 10, 2018
Last Updated: Dec 10, 2018

Practice Location

Address: 151 N 4TH AVE STE A
City: Pocatello
State: Idaho
ZIP Code: 83201-6300
Phone: (208) 226-4434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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