Individual
BYRON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
843 WAKE FOREST BUSINESS PARK STE 110, WAKE FOREST, NC 27587
(919) 570-7080
(919) 570-7081
Mailing address
843 WAKE FOREST BUSINESS PARK STE 110, WAKE FOREST, NC 27587-6578
(919) 570-7080
(919) 570-7081
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
18051
NC
225100000X
Physical Therapist
40QA01762300
NJ
Other
Enumeration date
01/03/2018
Last updated
07/13/2018
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