MEDICARE: MR. PEDRO SAUL MORENO A.T.C.

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	174400000X	Specialist	AT0038	MS

General Provider Information

NPI Number	:	1134285273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PEDRO SAUL MORENO A.T.C.

Provider Business Mailing Address
First Line	:	273 MACEDONIA RD
Second Line	:
City	:	PETAL
State	:	MS
Zip	:	39465-9767
Country	:	US
Telephone Number	:	601-545-8329
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 HIGHWAY 42
Second Line	:
City	:	PETAL
State	:	MS
Zip	:	39465-9740
Country	:	US
Telephone Number	:	601-544-0500
Fax Number	:

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

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1780646943 — ANNA CHRISTINE POWELL ATC, LAT, CSCS
Practice Location Address:

1145 HIGHWAY 42
PETAL, MS
39465-9740

Practice Phone: 601-544-0500
Practice Fax: 601-544-0505

1447359229 — JOHN PAUL BUMGARDNER PT
Practice Location Address:

1145 HIGHWAY 42
PETAL, MS
39465-9740

Practice Phone: 601-544-0500
Practice Fax: 601-544-0505

1932446051 — PETAL ELEMENTARY SCHOOL
Practice Location Address:

1179 HIGHWAY 42
PETAL, MS
39465-9740

Practice Phone: 601-545-8700
Practice Fax: 601-450-2493

1003153073 — PETAL HIGH SCHOOL
Practice Location Address:

1145 HIGHWAY 42
PETAL, MS
39465-9740

Practice Phone: 601-545-8700
Practice Fax: 601-450-2493

1629911698 — MAGNOLIA ORTHODONTICS OF PETAL, PLLC
Practice Location Address:

35 BEECH LN
PETAL, MS
39465-9457

Practice Phone: 601-305-9955
Practice Fax: 601-305-9977

1710984539 — GERALYNN G. MORRISON M.D.
Practice Location Address:

102 RED MAPLE TRL
PETAL, MS
39465-2678

Practice Phone: 601-310-6455
Practice Fax:

Directions to “ MR. PEDRO SAUL MORENO A.T.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.