Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH EARL MOORE, ATC
ActiveKENNETH EARL MOORE, ATC is a Athletic Trainer healthcare provider located in IDABEL, Oklahoma. NPI 1669409967 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · IDABEL, OK
Registration Details
- NPI Number
- 1669409967
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 26, 2006 (20.121146117874 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AT-66 (OK)
Practice Information
- Address
-
901 LINCOLN RDIDABEL, OK, 747457802Browse OK providers · Browse ZIP 74745
- Phone
- 5802129785
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.