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General NPI Number Information
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NPI Number | 1225014962
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Entity Type | Individual
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Provider Name | MELISSA ANN MOORE P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 231 GRANITE RUN DR
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City | LANCASTER
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State | PA
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Zip | 17601-6823
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Country | US
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Telephone | 717-560-4200
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Fax | 717-560-6380
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Provider Business Mailing Address
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Address Line | 4013 PARKSIDE CT
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City | MOUNT JOY
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State | PA
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Zip | 17552-9253
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Country | US
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Telephone | 717-560-4200
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Fax | 717-560-6380
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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 | PT007638L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-007638-L
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License Number State | PA
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