Individual
HEATHER MARIE MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
CLINCH MEMORIAL HOSPITAL, 1050 VALDOSTA HWY, HOMERVILLE, GA 31634
(912) 487-5211
(912) 487-4332
Mailing address
100 S MADISON ST, THOMASVILLE, GA 31792-5473
(229) 236-0831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5518
GA
Other
Enumeration date
08/23/2005
Last updated
10/27/2021
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