Individual
BRIAN TYLER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
527 MEDICAL PARK DR STE 500, BRIDGEPORT, WV 26330-9010
(681) 342-3600
Mailing address
9483 COST AVE UNIT 45, STONEWOOD, WV 26301-7806
(304) 997-1379
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2025
Last updated
03/28/2025
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