Individual
MARY LOUELLA MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E FOREST AVE, COLUMBIA, MO 65203-4067
(573) 874-0785
Mailing address
101 E FOREST AVE, COLUMBIA, MO 65203-4067
(573) 874-0785
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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