SUSAN MOORE
Individual Provider (NPI-1)
Active
Physical Therapist
Provider Information
- NPI Number
1225298169- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2814 S INDIANA AVE, CALDWELL, ID, 83605
- Phone
- (208) 459-0808
- Fax
- (208) 459-6668
Specialties & Taxonomies
Physical Therapy Assistant
License: ID #PTA-220
Physical Therapist
Primary License: ID #PT-5383