Organization
GRANT NH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS MOSS MD (MEMBER)
(229) 259-0032
Entity
Organization
Contact information
Practice address
814 NORTHWOOD PARK DR, VALDOSTA, GA 31602-1398
(229) 259-0032
Mailing address
814 NORTHWOOD PARK DR, VALDOSTA, GA 31602-1398
(229) 259-0032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/14/2008
Last updated
01/05/2012
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