Individual
JOE E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
780 PRAIRIE HOLLOW RD, OZARK, MO 65721-7471
(417) 300-4064
Mailing address
780 PRAIRIE HOLLOW RD, OZARK, MO 65721-7471
(417) 300-4064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008002441
MO
225100000X
Physical Therapist
4746-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007725040
AETNA
WI
05
—
40318700
—
WI
Enumeration date
11/01/2006
Last updated
09/29/2020
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