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1235722968
TENIQUA MOFFATTE
DOUGLASVILLE, GA
NPI
1235722968
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225000000X Orthotic Fitter
Enumeration Date
2021-02-13
Last Update Date
2021-02-13
Business Address
TENIQUA MOFFATTE
1688 JEFFERSON LN
DOUGLASVILLE, GA 30134-3249
Phone number: 470-848-2679
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Mailing Address
TENIQUA MOFFATTE
1688 JEFFERSON LN
DOUGLASVILLE, GA 30134-3249
Phone number: 470-848-2679
Copy