Individual
MR. MARK W MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, CWS
Contact information
Practice address
6036 N 19TH AVE STE 303, PHOENIX, AZ 85015
(602) 795-8441
(602) 795-8447
Mailing address
5100 ELDORADO PKWY # 102-20, MCKINNEY, TX 75070-6510
(214) 346-9105
(214) 346-9125
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7954
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1145845
TEXAS BOARD OF PHYSICAL THERAPISTS
TX
05
—
305782
—
AZ
Enumeration date
10/23/2006
Last updated
09/11/2025
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