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NPI Code Detail

MEDICARE: JAMES RAY MORAN

MEDICARE: JAMES RAY MORAN
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 Therapist2305212907VA

General Provider Information

NPI Number : 1730748781
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES RAY MORAN
Provider Business Mailing Address
First Line : 7302 KENNETH DR
Second Line :
City : RICHMOND
State : VA
Zip : 23228-4327
Country : US
Telephone Number : 804-687-4919
Fax Number :
Provider Business Practice Location Address
First Line : 3100 W MARSHALL ST
Second Line :
City : RICHMOND
State : VA
Zip : 23230-4706
Country : US
Telephone Number : 804-687-4919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2019
Last Update Date : 06/20/2019

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