MEDICARE: MRS. CYNTHIA SEYMOUR MOORE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT2782	TN

General Provider Information

NPI Number	:	1013942721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA SEYMOUR MOORE PT

Provider Business Mailing Address
First Line	:	135 MAPLETON FOREST DR NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-6237
Country	:	US
Telephone Number	:	423-478-2798
Fax Number	:	423-479-8300

Provider Business Practice Location Address
First Line	:	440 STUART RD NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-4985
Country	:	US
Telephone Number	:	423-618-5618
Fax Number	:	423-479-8300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/20/2009

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