Rhonda Penelope Moore, LPTA

Individual provider Active NPI Physical Therapy Assistant · Waynesboro, TN

NPI 1891967592 · NPPES record last updated Apr 2, 2008

Key facts

NPI
1891967592
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2657 (TN)
Practice address
103 JV Mangubat Dr
Waynesboro, TN 38485-2440
Phone
(931) 722-2041
Fax
(931) 722-2040
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2657TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2657 TN Yes

Addresses

Primary practice location

103 JV Mangubat Dr
Waynesboro, TN 38485-2440

Mailing address

103 JV Mangubat Dr
Waynesboro, TN 38485-2440
Phone (931) 722-2041

Other providers in Waynesboro, TN

All providers in Waynesboro, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.