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General NPI Number Information
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NPI Number | 1134496854
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Entity Type | Individual
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Provider Name | JUDITH MARIE MOORE PT
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Gender | Female
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 610 E BRANNON RD STE 200
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-6046
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Country | US
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Telephone | 859-260-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7217
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Fax |
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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 | 1212495
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 1212495
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 1212496
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 007094
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1212495
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License Number State | TX
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