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NPI Code Detail

MEDICARE: MRS. ALLISON SKILLMAN MOORE PT, MHA, MBA

MEDICARE:  MRS. ALLISON SKILLMAN MOORE  PT, MHA, MBA
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 Therapist
2225100000XPhysical Therapist11115NC

General Provider Information

NPI Number : 1205189990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALLISON SKILLMAN MOORE PT, MHA, MBA
Provider Business Mailing Address
First Line : PO BOX 601791
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-1791
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6915 VILLAGE MEDICAL CIR
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8002
Country : US
Telephone Number : 336-893-2512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2012
Last Update Date : 05/21/2020

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Directions to “ MRS. ALLISON SKILLMAN MOORE PT, MHA, MBA” Practice Location

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