Individual
NICHOLAS DANIEL MOES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 W ALLUVIAL AVE, CLOVIS, CA 93611-6716
(559) 323-6200
Mailing address
317 N PARK AVE, FRESNO, CA 93701-1738
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA49217
CA
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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