Individual
MISS KRISTY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3258 OVERLAND AVE APT 8, LOS ANGELES, CA 90034-3583
(310) 903-2524
Mailing address
3258 OVERLAND AVE APT 8, LOS ANGELES, CA 90034-3583
(310) 903-2524
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6798
CA
225200000X
Physical Therapy Assistant
PTA-481
WY
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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