Provider Demographics
NPI:1447379664
Name:MOONEY, DAVID W (DPT, OCS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:MOONEY
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6409
Mailing Address - Country:US
Mailing Address - Phone:318-238-6683
Mailing Address - Fax:
Practice Address - Street 1:4133 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6409
Practice Address - Country:US
Practice Address - Phone:318-238-6683
Practice Address - Fax:833-733-6683
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA049852251X0800X, 225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic