Provider Demographics
NPI:1659908218
Name:MOORE, KAREN BARBARA (MHS PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:BARBARA
Last Name:MOORE
Suffix:
Gender:F
Credentials:MHS PT
Other - Prefix:
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Mailing Address - Street 1:1410 BEACON HL
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:VA
Mailing Address - Zip Code:22920-9600
Mailing Address - Country:US
Mailing Address - Phone:434-882-0676
Mailing Address - Fax:540-456-6076
Practice Address - Street 1:4405 IVY CMNS
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-7123
Practice Address - Country:US
Practice Address - Phone:434-249-3756
Practice Address - Fax:540-456-6076
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist