Individual
MR. ANDREW L. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
420-B MCNULTY ROAD P.O. BOX 219, BLYTHEWOOD, SC 29016-8926
(803) 728-0421
Mailing address
420-B MCNULTY ROAD P.O. BOX 219, BLYTHEWOOD, SC 29016-8926
(803) 728-0421
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6817
SC
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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