Provider Demographics
NPI:1013680529
Name:BYRNE, MORIAH ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MORIAH
Middle Name:ELIZABETH
Last Name:BYRNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:ELIZABETH
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6285 ASHRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-2107
Mailing Address - Country:US
Mailing Address - Phone:406-552-9320
Mailing Address - Fax:
Practice Address - Street 1:15 S WEBER ST STE A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1920
Practice Address - Country:US
Practice Address - Phone:719-630-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0017745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist