Benjamin R Moore, PT

NPI #1033240981 in Jackson, Wyoming

Provider Information

NPI Number: 1033240981
Entity Type: Individual
Name: Benjamin R Moore, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Mar 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 555 EAST BROADWAY
Address 2: SUITE 100
City: Jackson
State: Wyoming
ZIP Code: 83001
Phone: (307) 739-7491

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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