Individual
ELIZABETH EMMONS MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
50 E HOSPITAL ST, MANNING, SC 29102-3149
(843) 435-3162
Mailing address
22 PUTTER DR, SUMTER, SC 29150-8607
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9328
SC
Other
Enumeration date
08/03/2019
Last updated
08/03/2019
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