Provider Demographics
NPI:1437393428
Name:MOORE, REBEKAH C (CMT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:C
Last Name:MOORE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N LYNHURST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-8823
Mailing Address - Country:US
Mailing Address - Phone:317-908-5681
Mailing Address - Fax:
Practice Address - Street 1:997 E COUNTY LINE RD
Practice Address - Street 2:SUITE M
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1075
Practice Address - Country:US
Practice Address - Phone:317-881-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist