| Doctor Name: | MRS. GWENDOLYN A MOE |
| NPI Number: | 1750582474 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHYSICAL THERAPIST |
| License Number: | 118477 |
| Business Practice Address: | 1432 Southwest Blvd Jefferson City, MO - 651092444 |
| Business Phone Number: | 5736325440 |
| Business Fax Number: | 5736325990 |
| Mailing Address: | 5505 Prairie Creek Dr, COLUMBIA |
| State: | MO |
| Postal Code: | 65203 |
| Phone Number: | 5732892229 |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 118477 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| 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 |