Individual
LAURA MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
750 WASHINGTON ST, BOX 419, BOSTON, MA 02111-1526
(617) 636-5630
Mailing address
24 LINDEN AVE, #3, SOMERVILLE, MA 02143-2224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17457
MA
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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