MEDICARE: MS. CHRISTINE A MORAN MS PT

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	2305001100	VA
2	2251H1200X	Hand Physical Therapist	9105000004	VA

General Provider Information

NPI Number	:	1689633737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE A MORAN MS PT

Provider Business Mailing Address
First Line	:	PO BOX 71076
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23255-1076
Country	:	US
Telephone Number	:	804-839-0164
Fax Number	:	866-816-9721

Provider Business Practice Location Address
First Line	:	1601 ROLLING HILLS DR
Second Line	:	SUITE 104
City	:	RICHMOND
State	:	VA
Zip	:	23229-5011
Country	:	US
Telephone Number	:	804-839-0164
Fax Number	:	866-816-9721

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	09/12/2008

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