Jesse Moore, DPT, MBA

NPI #1043555410 in Glen Carbon, Illinois

Provider Information

NPI Number: 1043555410
Entity Type: Individual
Name: Jesse Moore, DPT, MBA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT, MBA
Enumeration Date: Dec 11, 2012
Last Updated: Dec 11, 2012

Practice Location

Address: 3008 HUNTSVILLE DR
City: Glen Carbon
State: Illinois
ZIP Code: 62034-3046
Phone: (317) 691-6262

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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