Individual
ANTHONY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11050 MT BELVEDERE BLVD, FORT DRUM, NY 13602-2603
(888) 838-1303
Mailing address
5489 CYPRESS PT, SCHERTZ, TX 78108-2509
(810) 877-5451
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TX
Other
Enumeration date
10/03/2023
Last updated
04/13/2026
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