Individual
GEOFFREY PAUL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3050 CENTRE POINTE DR STE 200, ROSEVILLE, MN 55113-1179
(651) 631-4242
Mailing address
3050 CENTRE POINTE DR STE 200, ROSEVILLE, MN 55113-1179
(651) 631-4242
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A704
MN
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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