Provider Demographics
NPI:1013222900
Name:MOYNIHAN, MARGARET EILEEN (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EILEEN
Last Name:MOYNIHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 BRADY LN
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-5201
Mailing Address - Country:US
Mailing Address - Phone:805-709-7763
Mailing Address - Fax:
Practice Address - Street 1:2480 BRADY LN
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-5201
Practice Address - Country:US
Practice Address - Phone:805-709-7763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist