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Individual

MRS. JOAN PAULINE MOULTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
2200 INDEPENDENCE PKWY, PLANO, TX 75075-3143
(469) 752-9518
Mailing address
18665 MIDWAY RD APT 1912, DALLAS, TX 75287-3951
(972) 977-6856

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
TX

Other

Enumeration date
05/08/2007
Last updated
07/08/2007
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