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Individual

CHRISTOPHER PAUL MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
2204 IRONWOOD PL, SUITE A, COEUR D ALENE, ID 83814-2662
(208) 765-0597
(208) 765-0598
Mailing address
2204 IRONWOOD PL, SUITE A, COEUR D ALENE, ID 83814-2662
(208) 765-0597
(208) 765-0598

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000417
WA
224P00000X
Prosthetist
Primary
PS00000418
WA

Other

Enumeration date
06/08/2011
Last updated
06/08/2011
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