Individual
KASIE KING MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4503 OLD MONROE RD, INDIAN TRAIL, NC 28079-5309
(980) 993-7100
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08796
NC
Other
Enumeration date
01/25/2019
Last updated
07/15/2024
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