Individual
D RUSSELL MOSHER
Active
Individual
D RUSSELL MOSHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202540
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00637713
MEDICARE RR
VA
Enumeration date
07/24/2006
Last updated
10/06/2011
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