Basic Information
Provider Information
NPI: 1134427149
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOYER
FirstName: CATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2001 MALLORY LN
Address2: SUITE 201
City: FRANKLIN
State: TN
PostalCode: 370678233
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 701 MED TECH PKWY
Address2: SUITE 301
City: JOHNSON CITY
State: TN
PostalCode: 376042365
CountryCode: US
TelephoneNumber: 4232328302
FaxNumber: 4237941485
Other Information
ProviderEnumerationDate: 03/01/2011
LastUpdateDate: 04/09/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X8876TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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