Individual
MARC WAYNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
2500 S POWER RD, STE 123, MESA, AZ 85209-6686
(480) 218-1344
(480) 218-1356
Mailing address
2500 S POWER RD, STE 123, MESA, AZ 85209-6686
(480) 218-1344
(480) 218-1356
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5048
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
706210
—
AZ
Enumeration date
06/10/2005
Last updated
07/18/2024
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