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General NPI Number Information
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NPI Number | 1891955191
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Entity Type | Individual
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Provider Name | VANESSA MOEN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 265 H ST UNIT 2
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City | LEWISTOWN
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State | MT
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Zip | 59457-4939
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Country | US
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Telephone | 406-535-2919
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Fax | 406-535-2920
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Provider Business Mailing Address
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Address Line | PO BOX 21150
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City | BOULDER
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State | CO
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Zip | 80308-4150
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Country | US
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Telephone | 406-535-2919
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Fax | 406-535-2920
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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 | 2251
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License Number State | MT
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