Provider Demographics
NPI:1558517110
Name:MOELLER, APRIL R (LPTA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:R
Last Name:MOELLER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16099 N 250TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:IL
Mailing Address - Zip Code:62411-2901
Mailing Address - Country:US
Mailing Address - Phone:618-292-6494
Mailing Address - Fax:
Practice Address - Street 1:16099 N 250TH ST
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:IL
Practice Address - Zip Code:62411-2901
Practice Address - Country:US
Practice Address - Phone:618-292-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160002150225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant