Organization
MELISSA K MOSS MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA KALEENA MOSS MD (PHYSICIAN)
(333) 333-3333
Entity
Organization
Contact information
Practice address
802 S 10TH ST STE C, LEESVILLE, LA 71446-4662
(337) 238-4189
Mailing address
802 S 10TH ST STE C, LEESVILLE, LA 71446-4662
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1490067
—
LA
Enumeration date
05/18/2017
Last updated
10/03/2019
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