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1255574059
KRAIG MOULTRIE
OMAHA, NE
NPI
1255574059
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NJ 40QB00258900)
Enumeration Date
2009-04-09
Last Update Date
2009-04-09
Business Address
Mr. KRAIG MOULTRIE P.T.A.
11623 ARBOR ST
OMAHA, NE 68144-2981
Phone number: 402-334-1919
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Mailing Address
Mr. KRAIG MOULTRIE P.T.A.
14 MARSHALL ST APT. 10R
IRVINGTON, NJ 07111-3656
Phone number: 862-754-0275
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