David Glen Moore, P.T.

Individual provider Active NPI Physical Therapist · Alpahretta, GA

NPI 1457398786 · NPPES record last updated Dec 22, 2011

Key facts

NPI
1457398786
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
5755 North Point Parkway
Suite 56
Alpahretta, GA 30022
Phone
(770) 908-0740
Fax
(770) 908-0463
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Exigence Medical of Olean, PLLC Past Accepting new patients
Fitness Forum of Georgia Physical Therapist Past Accepting new patients
Backstrong Non-Surgical Rehab Clinic Past
since Aug 30, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

5755 North Point Parkway
Suite 56
Alpahretta, GA 30022

Mailing address

2175 Northlake Parkway
Suite 137
Tucker, GA 30084
Phone (770) 908-0740

Sources for this page

Verify at the official NPI Registry.