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NPI Code Detail

MEDICARE: MELISSA A MOYER P.T.

MEDICARE: MELISSA A MOYER P.T.
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
1225100000XPhysical Therapist004170IA
2225100000XPhysical Therapist1445SD
3225100000XPhysical Therapist070-016452IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1004170OTHERIAIOWA PT LICENSE NUMBER
2070-016452OTHERILILLINOIS PT LICENSE NO

General Provider Information

NPI Number : 1083891295
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA A MOYER P.T.
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-2663
Fax Number :
Provider Business Practice Location Address
First Line : 1210 W 18TH ST STE G01
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-4651
Country : US
Telephone Number : 605-328-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 01/06/2026

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Directions to “ MELISSA A MOYER P.T.” Practice Location

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