Healthcare Provider Details

I. General information

NPI: 1093619140
Provider Name (Legal Business Name): THOMAS MORIARITY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FOREST DR STE 200
COLUMBIA SC
29204-4057
US

IV. Provider business mailing address

1226 BUTLER ST
COLUMBIA SC
29205-1349
US

V. Phone/Fax

Practice location:
  • Phone: 803-296-9207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1583
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: