Moore, Amelia B

Moore, Amelia B is an individual health care provider with primary practice located at 290 Brandywine Blvd , Fayetteville GA 30214-1560. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Moore, Amelia B can be contacted via phone (770) 460-0165.

Contact Information

Primary practice address
290 Brandywine Blvd Fayetteville GA 30214-1560
Phone: (770) 460-0165
Fax: (770) 460-0189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT003365 Georgia

Profile Details

NPI number 1740364264
LBN Legal business name Moore, Amelia B
Credentials O.T.R/L
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Jul 18th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740364264 NPPES
Georgia MEDICAID 000924822D

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