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1972115582
MICHAEL SHANE MOORE
MONTGOMERY, AL
NPI
1972115582
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: AL PTA9712)
Enumeration Date
2020-08-17
Last Update Date
2020-08-17
Business Address
MICHAEL SHANE MOORE LPTA
2757 VANDY CT
MONTGOMERY, AL 36110-1339
Phone number: 334-669-1430
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Mailing Address
MICHAEL SHANE MOORE LPTA
2757 VANDY CT
MONTGOMERY, AL 36110-1339
Phone number: 334-669-1430
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