Casey Moore

NPI #1225447246 in Normal, Illinois

Provider Information

NPI Number: 1225447246
Entity Type: Individual
Name: Casey Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Aug 4, 2014
Last Updated: Aug 4, 2014

Practice Location

Address: 509 N ADELAIDE ST
City: Normal
State: Illinois
ZIP Code: 61761-2422
Phone: (309) 451-0393

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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