Individual
JONATHAN MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Mailing address
15093 DOBSON RD, BILOXI, MS 39532-9130
(228) 218-7468
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT4488
MS
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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