Individual
SCOTT ROBERT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
565 S 250 E, IVINS, UT 84738-5010
(435) 674-1167
Mailing address
565 S 250 E, IVINS, UT 84738-5010
(435) 674-1167
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
267051-4701
UT
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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