Individual
THOMAS E MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
4130 DUTCHMANS LN STE 101, LOUISVILLE, KY 40207-4708
(502) 897-1794
(502) 897-3852
Mailing address
4130 DUTCHMANS LN STE 300, LOUISVILLE, KY 40207-4710
(502) 897-1794
(502) 897-3852
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 001154
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000367296
ANTHEM
—
05
—
201083180
—
IN
05
—
87000691
—
KY
Enumeration date
11/02/2005
Last updated
04/25/2018
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