Doctor Name: | MRS. CAROLE MALLONEE MOFFITT |
NPI Number: | 1972646719 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT 3010 |
Business Practice Address: | 1361 E Irlo Bronson Memorial Hwy Saint Cloud, FL - 347715823 |
Business Phone Number: | 4079571454 |
Business Fax Number: | 4079571706 |
Mailing Address: | 5295 Starline Dr, SAINT CLOUD |
State: | FL |
Postal Code: | 347719030 |
Phone Number: | 4077916943 |
Fax Number: | 4079571706 |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 3010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |