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General NPI Number Information
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NPI Number | 1699623793
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Entity Type | Organization
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Legal Business Name | MOE REHAB & SPORTS PERFORMANCE
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 614 LAMBS RD
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City | PITMAN
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State | NJ
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Zip | 08071-2000
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Country | US
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Telephone | 856-218-8091
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Fax |
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Provider Business Mailing Address
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Address Line | 229 SYLVAN AVE APT A
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City | GLOUCESTER CITY
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State | NJ
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Zip | 08030-1657
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Country | US
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Telephone | 856-264-9536
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL MOELLER
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Credential | PT, DPT, CSCS
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Telephone | 856-264-9536
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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 |
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License Number State |
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