Individual
SHAYLA MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
527 W 400 N STE 6, OREM, UT 84057-1951
(775) 217-1553
Mailing address
527 W 400 N STE 6, OREM, UT 84057-1951
(775) 217-1553
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9421703-2402
UT
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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