Most Relevant Information
Provider Data
| NPI Number: | 1003584392 |
| Provider Name: | SANDRA MICHELLE MOFFETT PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA22525 |
Most Important Dates
| Enumeration Date: | 09/01/2021 |
| Last Updated: | 09/01/2021 |
Provider Practice Location
2717 SE 36TH ST
OCALA
FL
344716839
Practice Location Phone/Fax
| Phone: | 3525866313 |
| Fax: |
Provider Mailing Location
2717 SE 36TH ST
OCALA
FL
344716839
Provider Mailing Phone/Fax
| Phone: | 3525866313 |
| Fax: |