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General NPI Number Information
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NPI Number | 1396998134
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Entity Type | Organization
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Legal Business Name | PATRICK DANIEL MOORE MOORE FOOT CLINIC
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 3811 29TH AVE STE 3
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City | KEARNEY
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State | NE
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Zip | 68845-1280
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Country | US
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Telephone | 308-237-2621
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Fax | 308-237-2023
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Provider Business Mailing Address
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Address Line | 3811 29TH AVE STE 3
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City | KEARNEY
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State | NE
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Zip | 68845-1280
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Country | US
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Telephone | 308-237-2621
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Fax | 308-237-2023
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Authorized Official
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Title or Position | PODIATRIST.OWNER
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Name | DR. PATRICK DANIEL MOORE
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Credential | DPM
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Telephone | 308-237-2621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 265
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License Number State | NE
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