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General NPI Number Information
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NPI Number | 1326936253
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Entity Type | Organization
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Legal Business Name | MUSTANG MOON EQUINE THERAPY, LLC
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 16335 SW 19TH ST
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City | OCALA
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State | FL
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Zip | 34481-8799
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Country | US
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Telephone | 352-620-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 16335 SW 19TH ST
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City | OCALA
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State | FL
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Zip | 34481-8799
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Country | US
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Telephone | 352-620-5311
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE JENNIFER MOORE
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Credential |
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Telephone | 352-620-5311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number |
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License Number State |
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