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General NPI Number Information
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NPI Number | 1568666204
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Entity Type | Individual
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Provider Name | PER KRISTIAN MOERK PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 3200 NORTHLINE AVE STE 160
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City | GREENSBORO
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State | NC
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Zip | 27408-7613
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Country | US
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Telephone | 336-545-5000
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Fax | 336-545-5020
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Provider Business Mailing Address
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Address Line | 1901 MOONEY ST
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3027
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Country | US
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Telephone | 336-716-8091
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Fax | 336-716-9253
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2869
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License Number State | NC
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