NPI 1114220993

Carly Moreau

Practitioner Physical Therapy Assistant Summit, MS

Practice location

Address: 4109 Highway 98 W, Summit, MS 39666-9132
Phone: (601) 276-3900

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 2075580 (TX)

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Registry record

NPI: 1114220993
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Dec 2010
Record last updated: 16 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.