Kimberly Anne Moore, C.O.T.A.

Individual provider Active NPI Occupational Therapy Assistant · West Union, IA

NPI 1386859692 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386859692
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
00750 (IA)
Practice address
112 Jefferson St
West Union, IA 52175-1022
Phone
(563) 423-7261
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00750IAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 00750 IA Yes

Addresses

Primary practice location

112 Jefferson St
West Union, IA 52175-1022

Mailing address

112 Jefferson St
West Union, IA 52175-1022
Phone (563) 423-7261

Other providers in West Union, IA

All providers in West Union, IA · Occupational Therapy Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.