Matthew J Moore, P.T.
Physical Therapist in Wausau, WI. Individual provider (NPI-1).
NPI number1457783136
StatusActive
Last updated in NPPESMar 27, 2020
Details
- NPI
- 1457783136
- Entity type
- Individual (NPI-1)
- Name
- Matthew J Moore
- Credential
- P.T.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2013
- Certification date
- Mar 27, 2020
- Last updated
- Mar 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 12501-24 | WI | Yes |
| 225100000X | Physical Therapist | 12501 | WI |
Practice location
225000 Hummingbird RdSte 100
Wausau, WI 54401-6312
Phone 715-359-6442 · Fax 715-393-0390
Mailing address
225000 Hummingbird RdSte 100
Wausau, WI 54401-6312
Phone 715-359-6442 · Fax 715-393-0390
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