Healthcare Provider Details

I. General information

NPI: 1093711590
Provider Name (Legal Business Name): ALICE LOUISE MONEYPENNY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE COBLE

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MOSS CREEK VLG
HILTON HEAD ISLAND SC
29926-1105
US

IV. Provider business mailing address

8 HOSPITAL CENTER BLVD STE 250
HILTON HEAD ISLAND SC
29926-8702
US

V. Phone/Fax

Practice location:
  • Phone: 843-836-7003
  • Fax: 843-836-7004
Mailing address:
  • Phone: 843-671-7342
  • Fax: 843-671-7343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8305
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8024
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: