Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dustin C Moore, PTA

Individual provider Physical Therapy Assistant · NPI 1265717912

Dustin C Moore, PTA is a Physical Therapy Assistant in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2011.

Licensed in
FL
In the registry since
2011
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

404 NW Hall Of Fame Dr
Lake City, FL 32055-4833
Phone: (386) 755-3164
Fax: (386) 755-3165
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Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 21966 (FL)

Record details

NPI number1265717912
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedOctober 13, 2011
Last updated in NPPESOctober 13, 2011

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