Individual provider · Type 1 NPI

Lacie Moore, P.T.A.

Physical Therapy Assistant · Ellicott City, MD

NPI number 1497023097 Active

Practice location

6011 University Blvd, Suite 120
Ellicott City, MD 21043-6074

Call (410) 203-0391 Map

Fax (410) 203-2707

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XA3664 (MD)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1497023097

Lacie Moore, P.T.A.'s National Provider Identifier is 1497023097, issued on Dec 9, 2011. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Ellicott City, MD. The record was last updated on Jul 16, 2012.