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NPI Code Detail

MEDICARE: RYAN MOORE

MEDICARE: RYAN MOORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant007393OH

General Provider Information

NPI Number : 1205309838
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN MOORE
Provider Business Mailing Address
First Line : 410 ADAMS RD
Second Line :
City : LOVELAND
State : OH
Zip : 45140-7225
Country : US
Telephone Number : 513-264-2968
Fax Number :
Provider Business Practice Location Address
First Line : 1701 LLANFAIR AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-2972
Country : US
Telephone Number : 513-681-4230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2019
Last Update Date : 01/07/2019

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Directions to “ RYAN MOORE ” Practice Location

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