Individual
KIMBERLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5105 N TIMOTHY WAY, MUNCIE, IN 47304-6196
(765) 215-4607
Mailing address
5105 N TIMOTHY WAY, MUNCIE, IN 47304-6196
(765) 215-4607
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007366A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05007366A
PHYSICAL THERAPY LICENSURE
IN
Enumeration date
11/14/2015
Last updated
04/23/2025
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