Individual
MR. BENJAMIN MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527-5681
(541) 476-6644
Mailing address
495 SW RAMSEY AVE., GRANTS PASS, OR 97527-5681
(541) 476-6644
(541) 472-5673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA174622
OR
Other
Enumeration date
09/20/2009
Last updated
11/12/2019
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