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Individual
MR. MICHAEL J MOORE
Active
Individual
MR. MICHAEL J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT FFAAOMPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7554
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT75540
BLUE SHIELD
—
01
—
PT7554
BLUE CROSS OF CA
—
Enumeration date
10/24/2006
Last updated
07/08/2007
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