Individual
MRS. JESSICA LYNN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5020
Mailing address
354 FRANKLIN ST, MANSFIELD, MA 02048-1659
(508) 339-8875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02043
RI
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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