| Doctor Name: | SHAWN A MOORE |
| NPI Number: | 1508946005 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT, CSCS |
| License Number: | PT08805 |
| Business Practice Address: | 1069 Delaware Ave Suite 102 Marion, OH - 433026464 |
| Business Phone Number: | 7403821734 |
| Business Fax Number: | 7403876918 |
| Mailing Address: | 218 Kitdare Dr, DELAWARE |
| State: | OH |
| Postal Code: | 430157077 |
| Phone Number: | 4196567084 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT08805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| 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 |