Individual
MR. GABRIEL DAVID MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
17 W VERNON AVE, PHOENIX, AZ 85003-1076
(928) 890-7596
Mailing address
17 W VERNON AVE, PHOENIX, AZ 85003-1076
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP052255
AZ
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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