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Individual

ALEX S MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
555 W SR 164, SALEM, UT 84653
(385) 203-1313
Mailing address
1055 N 500 W, ATT: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7304875-2401
UT
225100000X
Physical Therapist

Other

Enumeration date
02/01/2016
Last updated
11/27/2023
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