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Individual

SECILY MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
903 E 6TH ST, PANA, IL 62557-1803
(217) 823-2505
Mailing address
903 E 6TH ST, PANA, IL 62557-1803

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
01/12/2015
Last updated
08/04/2016
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