Organization
MOSSER CORPORATION
Active
Other names
Mosser's Shoes
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANDRA D COFFEE (MANAGEMENT SERVICES COORDINATOR)
(217) 351-5022
Entity
Organization
Contact information
Practice address
2460 WABASH AVE, SPRINGFIELD, IL 62704-4201
(217) 787-7022
(217) 787-7067
Mailing address
PO BOX 1037, CHAMPAIGN, IL 61824-1037
(217) 351-5022
(217) 351-5040
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
37681893
IL
Other
Enumeration date
02/02/2007
Last updated
08/01/2008
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