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Individual

EMILIE DIANNE MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 FAIRVIEW PARK DR, DUBLIN, GA 31021-2501
(478) 272-7494
(478) 272-2616
Mailing address
101 FAIRVIEW PARK DR, DUBLIN, GA 31021-2501
(478) 272-7494
(478) 272-2616

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003273
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA003273
PTA#
GA
Enumeration date
04/23/2014
Last updated
04/23/2014
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