Provider Demographics
NPI:1922984202
Name:MOORE, TOMI JO (PT)
Entity type:Individual
Prefix:MRS
First Name:TOMI
Middle Name:JO
Last Name:MOORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111-B LINCOLN PARK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069
Mailing Address - Country:US
Mailing Address - Phone:859-481-9008
Mailing Address - Fax:
Practice Address - Street 1:111-B LINCOLN PARK RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069
Practice Address - Country:US
Practice Address - Phone:859-481-9008
Practice Address - Fax:859-481-9008
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist