Individual
DIANE MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.R.T
Contact information
Practice address
150 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4306
(616) 685-1433
(616) 685-1437
Mailing address
150 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4306
(616) 685-1433
(616) 685-1437
Taxonomy
Speciality
Code
Description
License number
State
2279E1000X
Educational Registered Respiratory Therapist
Primary
4401001878
MI
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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