Doctor Name: | CONNIE W MOORE |
NPI Number: | 1063840163 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT1290 |
Business Practice Address: | 533b Keyway Dr Flowood, MS - 392328809 |
Business Phone Number: | 6014200717 |
Business Fax Number: | |
Mailing Address: | 533b Keyway Dr, FLOWOOD |
State: | MS |
Postal Code: | 392328809 |
Phone Number: | 6014200717 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2013 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT1290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |