Individual
JASON CURTIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
102 E COMMERCE CT, JEFFERSON CITY, TN 37760-3200
(865) 475-3101
(865) 475-9213
Mailing address
102 E COMMERCE CT, JEFFERSON CITY, TN 37760-3200
(865) 475-3101
(865) 475-9213
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7106
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3650168
MEDICARE PTAN
TN
Enumeration date
02/12/2008
Last updated
09/04/2013
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