Staci Jennifer Moore DPT

NPI 1124336490 - Physical Therapist - 225100000X

NPI Details
NPI 1124336490
Gender Female
Enumeration Date 09/20/2010
Last Updated 09/20/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
801 CORPORATE CENTER DR.
POMONA CA, 91768, US
Phone (909) 623-1954
Fax (909) 623-4988
Business Location
801 CORPORATE CENTER DR.
POMONA CA, 91768, US
Phone (909) 623-1954
Fax (909) 623-4988
Toxanomy
Taxonomy Code 225100000X
License State California
License Number 36505
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According to our database, Dr. Staci Jennifer Moore DPT NPI is 1124336490, taxonomy code is 225100000X and license number is 36505, license state is located at California. Staci Jennifer Moore DPT physically located at 801 Corporate Center Dr., Pomona CA, 91768. NPI Number Staci Jennifer Moore DPT has the Individual type.

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1124336490 NPI number is provided on an as is basis without warranty of any kind. 1124336490 is maintained by the National Plan & Provider Enumeration System. The contents of Staci Jennifer Moore DPT are for informational purposes only.