Individual
ADAM WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 247-1579
Mailing address
13249 KOMATITE WAY, UNIT 500, FISHERS, IN 46038-5441
(812) 236-5250
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001519A
IN
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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