Individual
RILEY AUSTIN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4880 NE GOODVIEW CIR, LEES SUMMIT, MO 64064-1996
(816) 478-4200
(816) 875-2598
Mailing address
5101 COLLEGE BLVD, LEAWOOD, KS 66211-1614
(816) 478-4200
(816) 875-2598
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-02694
KS
363A00000X
Physician Assistant
Primary
2020006739
MO
Other
Enumeration date
02/25/2020
Last updated
07/30/2024
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