Moore, Michael M
Moore, Michael M is an individual health care provider with primary practice located at 2021 Mahaney Ave , Tahlequah OK 74464-5794. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Moore, Michael M can be contacted via phone (918) 458-5115.Contact Information
Primary practice address
2021 Mahaney Ave
Tahlequah OK 74464-5794
Phone: (918) 458-5115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 6041 | Oklahoma |
Profile Details
| NPI number | 1023683760 |
|---|---|
| LBN Legal business name | Moore, Michael M |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2021 |
| Last updated | Sep 21st, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023683760 | NPPES |
| Oklahoma | MEDICAID | 200994650A |
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