Provider Demographics
NPI:1467068940
Name:MOORE, AMELIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9707 ANDERSON MILL RD STE 340
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-0018
Mailing Address - Country:US
Mailing Address - Phone:512-258-5300
Mailing Address - Fax:512-258-4475
Practice Address - Street 1:9707 ANDERSON MILL RD STE 340
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-0018
Practice Address - Country:US
Practice Address - Phone:512-258-5300
Practice Address - Fax:512-258-4475
Is Sole Proprietor?:No
Enumeration Date:2020-09-19
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic