Individual
LEIGH ANN MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6290 JUPITER DRIVE SUITE C, BELMONT, MI 49306
(616) 813-1521
Mailing address
5523 DIVISION AVE N, COMSTOCK PARK, MI 49321-8214
(616) 813-1521
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501008684
MI
Other
Enumeration date
09/27/2017
Last updated
06/16/2018
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