MEDICARE: DR. MARIAH CHRISTINA MOYER PT, DPT

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	PT017630	GA

General Provider Information

NPI Number	:	1326846940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIAH CHRISTINA MOYER PT, DPT

Provider Business Mailing Address
First Line	:	1500 MARIETTA RD NW STE 12
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3653
Country	:	US
Telephone Number	:	336-554-5324
Fax Number	:	770-450-8944

Provider Business Practice Location Address
First Line	:	1500 MARIETTA RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3653
Country	:	US
Telephone Number	:	336-554-5324
Fax Number	:	770-450-8944

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

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/07/2025

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