Individual
CAROLYN MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3206 N 4TH ST, LONGVIEW, TX 75605-5143
(903) 753-6635
(903) 753-1114
Mailing address
1007 PREMIER RD, LONGVIEW, TX 75604-5727
(903) 759-5467
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1016350
TX
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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