Individual
JERRY CHRISTOPHER MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
121A MAIN ST., BELMONT, MS 38827
(662) 454-0085
Mailing address
PO BOX 968, BELMONT, MS 38827-0968
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0952
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120497
—
MS
Enumeration date
11/17/2006
Last updated
07/09/2007
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