Individual
MR. JORDAN MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS, USAW
Contact information
Practice address
1800 LAKEWOOD DR, APT S4, PHENIX CITY, AL 36867-1867
(812) 760-9985
Mailing address
1800 LAKEWOOD DR, APT S4, PHENIX CITY, AL 36867-1867
(812) 760-9985
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
AT002893
GA
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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