Individual
BRIAN JUSTIN MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
841 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-2740
Mailing address
P.O. BOX 528, ATTN: BH MALONE HOME, BETHEL, AK 99559
(907) 543-2740
(907) 543-6729
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
06/19/2018
Last updated
06/19/2018
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