Organization
LISA MOORE, PT, DPT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MOORE PT, DPT (PRESIDENT)
(704) 975-0646
Entity
Organization
Contact information
Practice address
19511 S MAIN ST, CORNELIUS, NC 28031-8439
(704) 975-0646
Mailing address
PO BOX 218, CORNELIUS, NC 28031-0218
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
9807
NC
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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