| Doctor Name: | MAE MORENO |
| NPI Number: | 1538366927 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 05005457A |
| Business Practice Address: | 255 Meadow Dr Danville, IN - 461221415 |
| Business Phone Number: | 3177455451 |
| Business Fax Number: | |
| Mailing Address: | 6297 Canak Dr, AVON |
| State: | IN |
| Postal Code: | 461237435 |
| Phone Number: | 3178379449 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05005457A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |