Individual
MELZIE JONATHAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 N WILDER RD, PLANT CITY, FL 33566-7547
(813) 752-3611
Mailing address
701 N WILDER RD, PLANT CITY, FL 33566-7547
(813) 752-3611
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29303
FL
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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