IndividualActive
Carly Moreau
NPI 1114220993 · Physical Therapy Assistant · Summit, MS
Provider details
- NPI number
- 1114220993
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2075580 (TX)
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Registry dates
- Enumerated
- 2010-12-16
- Last updated
- 2010-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.