Individual
WATORIS MOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TRANSPORTER
Contact information
Practice address
8690 BROADWAY AVE, STE A, MERRILLVILLE, IN 46410-7034
(708) 679-4348
Mailing address
8690 BROADWAY AVE, STE A, MERRILLVILLE, IN 46410-7034
(708) 679-4348
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
5370280407
IN
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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