| Doctor Name: | JEREMIAH ZANE MOORE |
| NPI Number: | 1407184922 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 5649 |
| Business Practice Address: | 8495 Crater Lake Hwy U.s. Department Of Veterans Affairs - Sorcc White City, OR - 97503 |
| Business Phone Number: | 5418262111 |
| Business Fax Number: | |
| Mailing Address: | 2160 Crestbrook Rd Unit 5, MEDFORD |
| State: | OR |
| Postal Code: | 975046001 |
| Phone Number: | 5033414963 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2009 |
| NPI Last Update Date: | 08/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| 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 |