MS. Mysti Moore, PT

NPI #1154309482 in Lackland a F B, Texas

Provider Information

NPI Number: 1154309482
Entity Type: Individual
Name: MS. Mysti Moore, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Jan 6, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2200 BERGQUIST DR
Address 2: ATTENTION CREDENTIALS (CMC)
City: Lackland a F B
State: Texas
ZIP Code: 78236-9908
Phone: (210) 292-2095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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