Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENYON LAROYCE MOORE
Active Sole ProprietorKENYON LAROYCE MOORE is a Occupational Therapy Assistant healthcare provider located in WILTON, Arkansas. NPI 1588129803 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · WILTON, AR
Registration Details
- NPI Number
- 1588129803
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 1, 2019 (7.5727187685988 yrs)
- Last Updated
- Feb 1, 2019
- License
-
213345 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
310 SOUTH FOURTH STREETWILTON, AR, 71865Browse AR providers · Browse ZIP 71865
- Phone
- 8703313184
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.