Individual
JESSELYN JURILLA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1309 KEMPSVILLE RD, NORFOLK, VA 23502-2205
(757) 461-5001
Mailing address
247 WINDBROOKE LN, VIRGINIA BEACH, VA 23462-7272
(757) 490-5951
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203739
VA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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