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Individual

DANIEL TYLER MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
1650 COCHRANE CIR UNIT MEDDAC, FORT CARSON, CO 80913-4604
(717) 309-2018
Mailing address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17029
TX

Other

Enumeration date
04/29/2014
Last updated
07/24/2025
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