Individual
CANDACE R. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
25298 LEE HWY, ABINGDON, VA 24211-7460
(276) 698-3104
(276) 698-3110
Mailing address
25298 LEE HWY, ABINGDON, VA 24211-7460
(276) 698-3104
(276) 698-3110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00W495C01
MEDICARE LEGACY PIN
VA
01
—
193685
BLUECROSS BLUESHIELD
VA
01
—
TN0101
JOHN DEERE UNITED HEALTHC
VA
Enumeration date
01/26/2007
Last updated
03/12/2014
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