Individual
DONNELL RASHIED AKIEL MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-7975
Mailing address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-7975
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.027319
IL
225100000X
Physical Therapist
PT013433
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/21/2019
Last updated
01/01/2024
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