Individual
JANICE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
830 W BEACON RD APT 6, LAKELAND, FL 33803-2862
(863) 680-2966
Mailing address
830 W BEACON RD APT 6, LAKELAND, FL 33803-2862
(863) 680-2966
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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