Individual
AUSTIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2090 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 968-5201
Mailing address
4550 MINNETONKA BLVD APT 209, SAINT LOUIS PARK, MN 55416-5416
(651) 795-1778
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11612
MN
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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