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Individual

MR. THEODORE NATHANIEL MOSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT, CPMT II, CIMT

Contact information

Practice address
187 RUSSELL ST, HADLEY, MA 01035-9521
(413) 522-0658
Mailing address
678 BERNARDSTON RD, GREENFIELD, MA 01301-1104
(413) 522-0658

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9911-MT-MT
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9911-MT-MT
DIVISION OF PROFESSIONAL LICENSURE, BOARD OF REGISTRATION OF MASSA
MA
Enumeration date
09/06/2017
Last updated
09/06/2017
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