Individual
KYLE ANDRE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
600 S LIVINGSTON AVE, LIVINGSTON, NJ 07039-5419
(973) 740-9001
(973) 740-9007
Mailing address
91 21ST ST, IRVINGTON, NJ 07111-4558
(973) 373-1819
(973) 373-1819
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00186200
NJ
Other
Enumeration date
05/27/2007
Last updated
07/08/2007
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