Individual
MR. MICHAEL JOSEPH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
170 RIDGEDALE AVE, MADISON, NJ 07940-1295
(973) 593-3117
Mailing address
1001 WHISPERING WAY APT 193, ABERDEEN, NJ 07747-1983
(201) 741-8270
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00285700
NJ
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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