Individual
DR. BRADLEY KENT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2000 BLAKE BLVD, BOSSIER CITY, LA 71111-2232
(318) 383-6751
(318) 963-8797
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08553
LA
Other
Enumeration date
07/31/2013
Last updated
08/27/2019
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