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Individual
MRS. SANDRA LYNN MOORE
Active
Individual
MRS. SANDRA LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4935
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0777F
BCBS PROVIDER #
NC
01
—
6400324
UHC PROVIDER #
NC
01
—
808047
BLUE MEDICARE PROVIDER #
NC
01
—
97886
MEDCOST PROVIDER #
NC
01
—
P0005866
RR MEDICARE PROVIDER #
NC
Enumeration date
07/26/2006
Last updated
04/10/2008
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