Individual
THOMAS RYAN MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
1041 CHINABERRY DR STE 100, BOSSIER CITY, LA 71111-2466
(318) 746-1199
Mailing address
2164 SWEET BAY CIR, BOSSIER CITY, LA 71111-6726
(318) 422-0486
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
123285
TX
225X00000X
Occupational Therapist
Primary
333138
LA
Other
Enumeration date
01/03/2023
Last updated
10/23/2024
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