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Contact Information

HOLLY S MOORE, MSOTR/L
202 WEST DAVENPORT STREET
CROSSVILLE, IL62827
 Phone: 618-928-4801
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for HOLLY S MOORE · (Female)

NPI Number 1255648390
Status Active
Credentials MSOTR/L
Entity Individual
Enumeration date 09/10/2010
Last updated 09/10/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 056.008560
  • IN License # 31004566A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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