Organization
GARY M. MOSS, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M MOSS OD (OPTOMETRIST/ OWNER)
(734) 483-2100
Entity
Organization
Contact information
Practice address
1769 WASHTENAW RD, YPSILANTI, MI 48197-2020
(734) 483-2100
(734) 483-2060
Mailing address
1769 WASHTENAW RD, YPSILANTI, MI 48197-2020
(734) 483-2100
(734) 483-2060
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4901002648
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0931160001
SUPPLIER
MI
05
—
5069375
—
MI
Enumeration date
09/12/2007
Last updated
11/06/2009
Update your record
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