Individual provider · NPI-1
Janice Moore
Prosthetist · Lakeland, FL
NPI number1306227749
StatusActive
Last updated in NPPESJun 11, 2015
Details
- NPI
- 1306227749
- Entity type
- Individual (NPI-1)
- Name
- Janice Moore
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2015
- Last updated
- Jun 11, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224P00000X | Prosthetist | – | – | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | – | – |
Practice location
830 W Beacon Rd Apt 6Lakeland, FL 33803-2862
Phone 863-680-2966
Mailing address
830 W Beacon Rd Apt 6Lakeland, FL 33803-2862
Phone 863-680-2966
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