MEDICARE: MICHAL DESIREE 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
1	225700000X	Massage Therapist	MSG005860	PA

General Provider Information

NPI Number	:	1598000127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAL DESIREE MOORE

Provider Business Mailing Address
First Line	:	1940 E WALNUT LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-1312
Country	:	US
Telephone Number	:	215-764-5782
Fax Number	:	215-764-5782

Provider Business Practice Location Address
First Line	:	1940 E WALNUT LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-1312
Country	:	US
Telephone Number	:	215-764-5782
Fax Number	:	215-764-5782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2012
Last Update Date	:	12/08/2012

Similar Medicare Providers

1356397913 — LISA C OVERTON
Practice Location Address:

1940 E WALNUT LN
PHILADELPHIA, PA
19138-1312

Practice Phone: 215-548-2113
Practice Fax: 215-548-3009

1619923190 — DR. LISA CAROL OVERTON D.P.M.
Practice Location Address:

1940 E WALNUT LN
PHILADELPHIA, PA
19138-1312

Practice Phone: 215-548-2113
Practice Fax: 215-548-3009

1629137666 — QADAR KHAN M.D.
Practice Location Address:

702 W GIRARD AVE
PHILADELPHIA, PA
19123-1312

Practice Phone: 215-440-9547
Practice Fax:

1932269586 — DR. ANTHONY S. ABDALLA DC
Practice Location Address:

7115 TORRESDALE AVE
PHILADELPHIA, PA
19135-1312

Practice Phone: 215-332-3132
Practice Fax: 215-332-3122

1861686453 — MR. ORRIN ANTON COOPER
Practice Location Address:

7505 ELMWOOD AVE
PHILADELPHIA, PA
19153-1312

Practice Phone: 215-365-7414
Practice Fax: 215-365-7414

1649464256 — SHARE-A-RIDE TRANSPORTATION INC
Practice Location Address:

7505 ELMWOOD AVE
PHILADELPHIA, PA
19153-1312

Practice Phone: 215-365-7414
Practice Fax: 215-365-7414

Directions to “ MICHAL DESIREE MOORE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.