Individual
ANTHONY ALLEN MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 GINA LN, CHELSEA, OK 74016-1113
(918) 519-6097
Mailing address
304 GINA LN, CHELSEA, OK 74016-1113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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