Basic Information
| Provider Information | |||||||||
| NPI: | 1649469040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOATS | ||||||||
| FirstName: | ISAAC | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 FAIRFAX DR | ||||||||
| Address2: | SUITE 60 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222031762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035221060 | ||||||||
| FaxNumber: | 7035221080 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 18TH ST NW | ||||||||
| Address2: | SUITE LL4 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200363816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027751777 | ||||||||
| FaxNumber: | 2027758668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2007 | ||||||||
| LastUpdateDate: | 10/22/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT870832 | DC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.