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General NPI Number Information
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NPI Number | 1942724182
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Entity Type | Individual
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Provider Name | LINDSY RENAE MOORE DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 07/31/2017
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Provider Practice Location Address
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Address Line | 2475 BOARDWALK
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City | NORMAN
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State | OK
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Zip | 73069-6332
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Country | US
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Telephone | 405-447-1991
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 728
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City | WASHINGTON
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State | OK
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Zip | 73093-0728
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Country | US
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Telephone | 405-996-8311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5378
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License Number State | OK
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