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Individual
JOHN MOORE
Active
Individual
JOHN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
006430
KY
225100000X
Physical Therapist
014731
OH
225100000X
Physical Therapist
Primary
9041
SC
2251X0800X
Orthopedic Physical Therapist
P16648
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01381928
RAILROAD MEDICARE
KY
Enumeration date
07/21/2014
Last updated
01/04/2019
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