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NPI Code Detail

MEDICARE: MS. TERESA JEAN MOEN MSPT

MEDICARE: MS. TERESA JEAN MOEN MSPT
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 Therapist4375CO

General Provider Information

NPI Number : 1952627135
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERESA JEAN MOEN MSPT
Provider Business Mailing Address
First Line : 1252 LEYDEN ST
Second Line :
City : DENVER
State : CO
Zip : 80220-2803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1252 LEYDEN ST
Second Line :
City : DENVER
State : CO
Zip : 80220-2803
Country : US
Telephone Number : 720-489-0790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2010
Last Update Date : 04/14/2010

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Directions to “ MS. TERESA JEAN MOEN MSPT” Practice Location

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