Doctor Name: | LISA M MOULSE |
NPI Number: | 1982886198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 2305205181 |
Business Practice Address: | 1421 3rd St Sw Roanoke, VA - 240165204 |
Business Phone Number: | 5409822208 |
Business Fax Number: | 5409827637 |
Mailing Address: | 1421 3rd St Sw, ROANOKE |
State: | VA |
Postal Code: | 240165204 |
Phone Number: | 5409822208 |
Fax Number: | 5409827637 |
NPI Enumeration Date: | 11/29/2007 |
NPI Last Update Date: | 08/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2305205181 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |