Provider Demographics
NPI:1467493114
Name:MOESSNER, MATTHEW P (MPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:P
Last Name:MOESSNER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 FREMONT RD
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1721
Mailing Address - Country:US
Mailing Address - Phone:724-483-0911
Mailing Address - Fax:
Practice Address - Street 1:110 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3123
Practice Address - Country:US
Practice Address - Phone:724-437-0556
Practice Address - Fax:724-437-2566
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-018113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist