Organization
JANET MOULTON, INC.
Active
Other names
Pediatric Therapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAVERGNE (BILLING AGENT)
(904) 879-4230
Entity
Organization
Contact information
Practice address
13241 BARTRAM PARK BLVD UNIT 1913, JACKSONVILLE, FL 32258-5228
(904) 249-8893
(904) 372-0496
Mailing address
340 16TH AVE N STE B, JACKSONVILLE BEACH, FL 32250-4819
(904) 249-8893
(904) 372-0496
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
11/09/2020
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