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General NPI Number Information
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NPI Number | 1427753078
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Entity Type | Individual
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Provider Name | PEGGY ANN STOKES-MOORE
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 340 NEW BYHALIA RD STE 4A
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3717
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Country | US
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Telephone | 901-308-5878
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Fax |
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Provider Business Mailing Address
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Address Line | 7337 PEPPERMILL LN
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City | MEMPHIS
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State | TN
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Zip | 38125-3555
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Country | US
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Telephone | 773-815-3057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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