Individual
TIMOTHY WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7900 LEES SUMMIT RD, KANSAS CITY, MO 64139-1236
(816) 404-4862
(816) 404-7716
Mailing address
1223 S INDIAN AVE, TULSA, OK 74127-9122
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
10/09/2023
Last updated
03/30/2025
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