Individual
JENNIFER L MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8215 SHELBYVILLE RD, LOUISVILLE, KY 40222-5421
(502) 802-7554
Mailing address
8236 US HIGHWAY 60 E, MOREHEAD, KY 40351-8632
(502) 802-7554
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY-0342
KY
Other
Enumeration date
07/18/2010
Last updated
07/18/2010
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