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NPI Code Detail

MEDICARE: MICHELE A MOORE PT

MEDICARE: MICHELE A MOORE PT
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
1225100000XPhysical Therapist773SC

General Provider Information

NPI Number : 1922046259
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE A MOORE PT
Provider Business Mailing Address
First Line : 9101 WESLEYAN RD
Second Line : STE 100
City : INDIANAPOLIS
State : IN
Zip : 46268-3103
Country : US
Telephone Number : 800-603-6046
Fax Number : 317-884-3388
Provider Business Practice Location Address
First Line : 3100 TRADITION CIR
Second Line :
City : MT PLEASANT
State : SC
Zip : 29466-7200
Country : US
Telephone Number : 843-654-7945
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 06/05/2019

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Directions to “ MICHELE A MOORE PT” Practice Location

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