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Individual

MS. GINA MARIE MOLTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
601 W LINCOLN AVE, CASEYVILLE, IL 62232-1306
(618) 344-9355
(618) 344-9356
Mailing address
1724 HARVEST AVE, CAHOKIA, IL 62206-2334
(618) 337-1283
(618) 344-9356

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004618
IL

Other

Enumeration date
06/11/2012
Last updated
06/11/2012
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