MEDICARE: VALERIE MOUROT 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	1196440	TX

General Provider Information

NPI Number	:	1922936954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE MOUROT PT, DPT

Provider Business Mailing Address
First Line	:	6122 FAIRLONG RUN NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-8416
Country	:	US
Telephone Number	:	979-480-3945
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 EVANS MILL DR STE 205
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30157-1624
Country	:	US
Telephone Number	:	678-909-9278
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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