Individual
DR. CODY NICHOLAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8654 BIG BEND BLVD, WEBSTER GROVES, MO 63119-3839
(314) 962-2634
Mailing address
15489 LONG CASTLE FOREST CT, CHESTERFIELD, MO 63017-7447
(314) 322-4330
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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