Provider Demographics
NPI:1760582613
Name:MOORE, KARLA FRANCES (PT)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:FRANCES
Last Name:MOORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:FRANCES
Other - Last Name:DELONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1000 LOCUST ST
Mailing Address - Street 2:PHYSICAL THERAPY DEPT (18)
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2597
Mailing Address - Country:US
Mailing Address - Phone:775-786-7200
Mailing Address - Fax:775-337-2260
Practice Address - Street 1:1000 LOCUST ST
Practice Address - Street 2:PHYSICAL THERAPY DEPT (18)
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2597
Practice Address - Country:US
Practice Address - Phone:775-786-7200
Practice Address - Fax:775-337-2260
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV103391Medicare PIN