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General NPI Number Information
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NPI Number | 1043461650
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Entity Type | Individual
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Provider Name | ALEXANDRA MORAN MPT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 1014 SYCAMORE DR SUITE A
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City | DECATUR
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State | GA
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Zip | 30030-1644
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Country | US
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Telephone | 404-299-6060
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Fax | 404-299-6383
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Provider Business Mailing Address
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Address Line | 1014 SYCAMORE DR SUITE A
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City | DECATUR
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State | GA
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Zip | 30030-1644
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Country | US
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Telephone | 404-299-6060
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Fax | 404-299-6383
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT009317
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT012812L
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License Number State | PA
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