Individual
MELANIE MICHELLE MOEBES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Mailing address
5590 TRION COVE, NORCROSS, GA 30092
(770) 825-0015
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT006474
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00852178C
—
GA
01
—
307923
WELLCARE-AAKTS
GA
Enumeration date
11/27/2006
Last updated
09/30/2010
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