Individual
MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PTA
Contact information
Practice address
3910 S CAREFREE CIR STE B, COLORADO SPRINGS, CO 80917-3053
(719) 457-6001
Mailing address
3910 S CAREFREE CIR STE B, COLORADO SPRINGS, CO 80917-3053
(719) 457-6001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0012277
CO
225200000X
Physical Therapy Assistant
—
—
2255A2300X
Athletic Trainer
AT.0000502
CO
Other
Enumeration date
11/22/2019
Last updated
02/07/2023
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