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Daniel Moore

Rehabilitation Practitioner in Las Vegas, NV. Individual provider (NPI-1).

NPI number1679831713
StatusActive
Last updated in NPPESApr 6, 2023

Details

NPI
1679831713
Entity type
Individual (NPI-1)
Name
Daniel Moore
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 26, 2012
Certification date
Apr 6, 2023
Last updated
Apr 6, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner––Yes

Practice location

5301 Bromley Ave
Las Vegas, NV 89107-1724

Phone 702-608-0042

Mailing address

5301 Bromley Ave
Las Vegas, NV 89107-1724

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