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1447009220
BENJAMIN THOMAS MOORE
CHUBBUCK, ID
NPI
1447009220
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-9025)
Enumeration Date
2024-05-15
Last Update Date
2024-05-29
Business Address
BENJAMIN THOMAS MOORE DPT, PT
445 E CHUBBUCK RD
CHUBBUCK, ID 83202-1815
Phone number: 208-244-7794
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Mailing Address
BENJAMIN THOMAS MOORE DPT, PT
1411 FALLS AVE E STE 401
TWIN FALLS, ID 83301-3455
Phone number: 208-244-7794
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