Individual
JON THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, OCS
Contact information
Practice address
156 FRONT ST NE STE 180, SALEM, OR 97301-3479
(971) 239-3272
Mailing address
5355 NORMA AVE SE, SALEM, OR 97306-1596
(971) 239-3272
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5566
OR
Other
Enumeration date
12/17/2007
Last updated
11/16/2021
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