Individual
MR. MICAH MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
3100 SW 89TH ST, OKLAHOMA CITY, OK 73159-7900
(405) 602-8100
Mailing address
3208 SW 103RD ST, OKLAHOMA CITY, OK 73159-6042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3905
OK
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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