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1619635976
SHANTA MOULTON
BISMARCK, ND
NPI
1619635976
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-12-03
Last Update Date
2021-12-03
Business Address
SHANTA MOULTON
4001 LOCKPORT ST APT 315
BISMARCK, ND 58503-5581
Phone number: 815-735-7322
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Mailing Address
SHANTA MOULTON
4001 LOCKPORT ST APT 315
BISMARCK, ND 58503-5581
Phone number: 815-735-7322
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