Provider Demographics
NPI:1811265366
Name:ISENHOWER-MOYER, TERESA LYNN (PT/CPT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:ISENHOWER-MOYER
Suffix:
Gender:F
Credentials:PT/CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MOTLEY ST
Mailing Address - Street 2:P.O. BOX 124
Mailing Address - City:ESSEX
Mailing Address - State:IA
Mailing Address - Zip Code:51638-8021
Mailing Address - Country:US
Mailing Address - Phone:712-379-3835
Mailing Address - Fax:712-379-3834
Practice Address - Street 1:310 MOTLEY ST
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:IA
Practice Address - Zip Code:51638-8021
Practice Address - Country:US
Practice Address - Phone:712-379-3835
Practice Address - Fax:712-379-3834
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist