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NPI Code Detail

MEDICARE: AMY ELIZABETH MOORE

MEDICARE: AMY ELIZABETH MOORE
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 Therapist10725-024WI
2225100000XPhysical Therapist7673AZ

General Provider Information

NPI Number : 1427246016
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH MOORE
Provider Business Mailing Address
First Line : 1329 COPILOT WAY
Second Line :
City : HOBART
State : WI
Zip : 54115-7004
Country : US
Telephone Number : 920-265-9462
Fax Number :
Provider Business Practice Location Address
First Line : 5121 E BROADWAY RD
Second Line :
City : MESA
State : AZ
Zip : 85206-1308
Country : US
Telephone Number : 480-296-2680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2007
Last Update Date : 11/06/2023

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Directions to “ AMY ELIZABETH MOORE ” Practice Location

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