Michael P Moore, DPT
Individual provider Active NPI Physical Therapist · Lakeside, MT
NPI 1013427665 · NPPES record last updated Oct 10, 2017
Key facts
- NPI
- 1013427665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 13127 (MT)
- Practice address
- 306 Stoner Loop Ste 3
Lakeside, MT 59922-8601 - Phone
- (406) 844-0744
- Fax
- (406) 844-0759
- NPI assigned
- Oct 10, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13127 | MT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13127 | MT | Yes |
Addresses
Primary practice location
306 Stoner Loop Ste 3
Lakeside, MT 59922-8601
Mailing address
PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134
Other providers in Lakeside, MT
- Lakeside Chiropractic Clinic PC
- Lakeside Pharmacy LLC
- Lakeside Qru, Inc
- Abby Gene Lambeth
- Grace Matheson
- Nellie Faith O'Reilly
- Jonathan Carl Otto
- Pharmfill Inc
- Kimberly Rae Ring
- Chelsey Lynne Spence
All providers in Lakeside, MT · Physical Therapist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.