Healthcare Provider Details

I. General information

NPI: 1437968898
Provider Name (Legal Business Name): CHLOE ELIZABETH MOYER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 GIVLER DR
MARTINSBURG PA
16662-1635
US

IV. Provider business mailing address

PO BOX 333
NEWRY PA
16665-0333
US

V. Phone/Fax

Practice location:
  • Phone: 814-793-3728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberTEI006244
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: