| Elise Miranda Princehouse Moore, DPT | |
|
602a Front St, Silverton, OR 97381-1428 | |
| (503) 874-4416 | |
| Not Available |
| Full Name | Elise Miranda Princehouse Moore |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 602a Front St, Silverton, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235796293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 63267 (Oregon) | Primary |
| Provider Name | Promotion Advanced Functional Rehab Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1710932710 PECOS PAC ID: 1759391394 Enrollment ID: O20060427000203 |
| Mailing Address | Practice Location Address |
|---|---|
| Elise Miranda Princehouse Moore, DPT 601 N 1st Ave, Stayton, OR 97383-1704 Ph: (503) 769-3123 | Elise Miranda Princehouse Moore, DPT 602a Front St, Silverton, OR 97381-1428 Ph: (503) 874-4416 |
Mrs. Leah Peldyak Schmidt, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 111 W C St, Silverton, OR 97381 Phone: 503-873-6111 Fax: 503-873-6113 | |
Casandra L Hart, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 240 Phelps St, Silverton, OR 97381 Phone: 503-873-1647 | |
Michael Lane Nored, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 111 W C St, Silverton, OR 97381 Phone: 503-873-6111 Fax: 503-873-6113 | |
Capitol Physical & Hand Therapy Ii Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 111 West C St, Silverton, OR 97381 Phone: 503-873-6111 Fax: 503-873-6113 | |
Peter E Heuberger, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 342 Fairview St, Silverton, OR 97381 Phone: 503-371-8860 Fax: 503-371-8772 | |
Jewel Derin, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 111 W C St, Silverton, OR 97381 Phone: 503-873-6111 Fax: 503-873-6113 |