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NPI Code Detail

MEDICARE: MR. HARRY LEE MOORE P.T.

MEDICARE: MR. HARRY LEE MOORE 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 Therapist1576NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
207802OTHERNCBCBS

General Provider Information

NPI Number : 1538183710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HARRY LEE MOORE P.T.
Provider Business Mailing Address
First Line : 2503 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9401
Country : US
Telephone Number : 919-734-1311
Fax Number : 919-734-8816
Provider Business Practice Location Address
First Line : 2503 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9401
Country : US
Telephone Number : 919-734-1311
Fax Number : 919-734-8816
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 02/07/2008

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