Individual
JOI MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
226 FAIRVIEW RD, ELLENWOOD, GA 30294-2704
(800) 381-2195
Mailing address
380 BROOK HOLLOW DR, MCDONOUGH, GA 30252-3956
(770) 895-3221
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007761
GA
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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