Provider Demographics
NPI:1093711590
Name:MONEYPENNY, ALICE LOUISE (PT)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:LOUISE
Last Name:MONEYPENNY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:COBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 HOSPITAL CENTER BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-8702
Mailing Address - Country:US
Mailing Address - Phone:843-671-7342
Mailing Address - Fax:843-671-7343
Practice Address - Street 1:15 MOSS CREEK VLG
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1105
Practice Address - Country:US
Practice Address - Phone:843-836-7003
Practice Address - Fax:843-836-7004
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8305225100000X
SC8024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2418502Medicaid
OHM04105202Medicare ID - Type Unspecified