Individual
JENNIFER MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
1217 IRA E WOODS AVE, GRAPEVINE, TX 76051-4023
(817) 481-8585
Mailing address
3200 SUMMIT CT, GRAPEVINE, TX 76051-4234
(817) 821-6946
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1123511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123511
LICENSE#
TX
Enumeration date
08/17/2007
Last updated
08/13/2019
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