Individual
MR. THADDEUS L MOORE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 WASHINGTON AVE, CHESTERTOWN, MD 21620-1438
(410) 778-7243
(410) 778-7741
Mailing address
924 GATEWAY DR, CHESTERTOWN, MD 21620-3325
(410) 810-3642
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/29/2005
Last updated
07/08/2007
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