Individual
SHANNON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
235 OPEN SKY WAY, KILA, MT 59920-7700
(678) 554-8088
Mailing address
PO BOX 752, KILA, MT 59920-0752
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT013525
GA
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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