Provider Demographics
NPI:1184115552
Name:MOATS, AMELIA CELESTE (DPT)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:CELESTE
Last Name:MOATS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:HALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1500 GRAND CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-1079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2036 SCHORRWAY DR NW STE 4
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8410
Practice Address - Country:US
Practice Address - Phone:740-304-0285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist