Justin L Moore, DPT
Individual provider Active NPI Specialist · Fairmount City, PA
NPI 1366444267 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1366444267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- PT013701L (PA)
- Practice address
- 987 Brookville St
Fairmount City, PA 16224-0046 - Phone
- (814) 275-1000
- Fax
- (814) 275-1003
- NPI assigned
- Aug 11, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT013701L | PA | Yes |
Addresses
Primary practice location
987 Brookville St
Fairmount City, PA 16224-0046
Mailing address
PO Box 46
987 Brookville Street
Fairmount City, PA 16224-0046
Phone (814) 275-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MO1543448 | Other | PA | BLUE CROSS INDEMNITY |
Other providers in Fairmount City, PA
- Tara Lynn Keister
- Jamie Mangini
- Crystal Meier
- Marcy L Monrean
- Moore Physical Therapy Inc.
- Ahmad Nabatchi
- Abigail Kathleen Selfridge
- Jayme L Shaffer
- Lana J Smith
- Barry James Snyder
All providers in Fairmount City, PA · Specialist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.