Individual
MR. JAMES MOATES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
317 NEW NEELY FERRY RD STE 1, MAULDIN, SC 29662-2659
(864) 535-5540
(866) 209-0069
Mailing address
PO BOX 1505, SIMPSONVILLE, SC 29681-1505
(864) 535-5540
(866) 209-0069
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
008627627
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-1451795
—
SC
Enumeration date
11/16/2021
Last updated
11/16/2021
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