Individual
JASON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5701 SHELTON ST, FORT WORTH, TX 76112-3929
(817) 815-4086
Mailing address
1612 MILLEDGE RD, FORT WORTH, TX 76120-1800
(713) 705-5141
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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