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SUSAN P MOORE PT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1659511350
Individual Registrant: SUSAN P MOORE PT
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4747 N OCEAN DR STE 261 LAUDERDALE BY THE SEA, FL 33308-2947 US
Tel: 954-785-4776 Fax: --
Tel: 954-785-4776 Fax: --
Contact information for business:
2725 NE 25TH PL FT LAUDERDALE, FL 33305-1705 US
Tel: 954-561-6962 Fax: --
Tel: 954-561-6962 Fax: --
Registration Information:
NPI: 1659511350
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | FL | PT4201 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| STATE LICENSE NUMBER | PT4201 | FL | 01 |
