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Individual

MR. JASON WAYNE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
2021 COLUMBUS AVE, WASHINGTON COURT HOUSE, OH 43160-9094
(740) 333-7848
(740) 333-1212
Mailing address
2150 STATE ROUTE 187, LONDON, OH 43140-9625
(740) 852-6926

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT9304
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2572943
OH
Enumeration date
02/12/2007
Last updated
07/08/2007
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