Individual
MR. TIMOTHY MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ABOC
Contact information
Practice address
1568 N FARWELL AVE, MILWAUKEE, WI 53202-2639
(414) 221-7055
Mailing address
4312 ABBOTT AVE N, ROBBINSDALE, MN 55422-1415
(713) 591-7781
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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