Moore, Terry J

Moore, Terry J is an individual health care provider with primary practice located at W3124 Van Roy Rd , Appleton WI 54915-3982. 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, Terry J can be contacted via phone (920) 968-1010.

Contact Information

Primary practice address
W3124 Van Roy Rd Appleton WI 54915-3982
Phone: (920) 968-1010
Fax: (920) 968-1012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5573 Wisconsin

Profile Details

NPI number 1720080492
LBN Legal business name Moore, Terry J
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Jul 18th, 2008 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1720080492 NPPES
Wisconsin MEDICAID 40358100

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