Individual
MRS. REBECCA NORTHERN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, MDT
Contact information
Practice address
210 CREEKSIDE DR, DICKSON, TN 37055-2176
(615) 446-7623
(615) 446-7624
Mailing address
PO BOX 306393, NASHVILLE, TN 37230-6393
(615) 373-1350
(615) 221-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6886
TN
2251X0800X
Orthopedic Physical Therapist
PT0000006886
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0000006886
TN LICENSE
TN
Enumeration date
08/29/2006
Last updated
07/19/2021
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