Individual
MOONSUNG JO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
2510 W RIO SALADO PKWY, MESA, AZ 85201-3603
(617) 755-4569
Mailing address
2510 W RIO SALADO PKWY, MESA, AZ 85201-3603
(617) 755-4569
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1488
AZ
2255A2300X
Athletic Trainer
AT-AT-10171243
OR
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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