Individual
KATHY JOANN MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
OLD ROUTE 220, TIPTON, PA 16684
(814) 684-4600
(814) 684-5557
Mailing address
PO BOX 334, TIPTON, PA 16684
(814) 684-4600
(814) 684-5557
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001092L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009410110001
—
PA
Enumeration date
03/06/2007
Last updated
07/08/2007
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