Moore, Kevin Dwayne

Moore, Kevin Dwayne is an individual health care provider with primary practice located at 500 W Aqua Ave , Coeur D Alene ID 83815-7764. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Moore, Kevin Dwayne can be contacted via phone (208) 762-1122.

Contact Information

Primary practice address
500 W Aqua Ave Coeur D Alene ID 83815-7764
Phone: (208) 762-1122
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA344 Idaho

Profile Details

NPI number 1124286109
LBN Legal business name Moore, Kevin Dwayne
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2008
Last updated May 27th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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