Holly Suzanne Moore, MSOTR/L Valid NPI
Individual provider · Skilled Nursing Facility · Crossville, IL
- NPI
- 1255648390
- Type
- Individual (Type 1)
- Primary specialty
- Skilled Nursing Facility
- Specialty group
- Nursing & Custodial Care Facilities
- Taxonomy code
- 314000000X
- License number
- 056.008560 (IL)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2010-09-10
- Last updated
- 2010-09-10
Practice location
202 West Davenport Street
Crossville, IL 62827
(618) 928-4801