Individual
CHRISTOPHER ANTHONY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
610 W 4TH ST, STORM LAKE, IA 50588-1713
(712) 749-2254
Mailing address
5935 TANNER LN, STEWARTSTOWN, PA 17363-8406
(717) 916-2970
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
110058
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
09/02/2019
Last updated
01/02/2024
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