Michael Moore

NPI #1750747564 in Powell, Wyoming

Provider Information

NPI Number: 1750747564
Entity Type: Individual
Name: Michael Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Jan 8, 2016
Last Updated: Jan 8, 2016

Practice Location

Address: 220 PEBBLE CREEK RD
City: Powell
State: Wyoming
ZIP Code: 82435-2271
Phone: (307) 254-3560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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