Individual
JACOB A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
240 S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6076
(505) 373-2836
Mailing address
7849 TRAMWAY BLVD NE STE A, ALBUQUERQUE, NM 87122-2529
(505) 485-4176
(505) 212-0786
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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