Individual
LEIGHTON ALONZO MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5116 MALIBU CT, DAYTON, OH 45426-2353
(937) 853-7646
Mailing address
5116 MALIBU CT, DAYTON, OH 45426-2353
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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