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Individual

CRAIG PAUL MOORHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1440 SUNCREST DR, GRAY, TN 37615-4118
(423) 477-1600
Mailing address
220 ALFALFA LN, JONESBOROUGH, TN 37659-3175
(423) 202-2355

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
394
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
394
ATHLETIC TRAINING LICENSE
TN
Enumeration date
09/16/2005
Last updated
11/24/2016
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