Individual
CHAD A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3819 E FOXTAIL DR, FLAGSTAFF, AZ 86004-7697
(928) 225-0287
Mailing address
3819 E FOXTAIL DR, FLAGSTAFF, AZ 86004-7697
(928) 225-0287
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6193
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127444
—
AZ
Enumeration date
11/20/2006
Last updated
11/11/2015
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