Individual
ZACHARY GORDON MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
223 PINE BRANCH CIR, COLUMBUS, GA 31909-2121
(706) 566-2569
Mailing address
223 PINE BRANCH CIR, COLUMBUS, GA 31909-2121
(706) 566-2569
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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