Individual
MADISON SPENCER MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
625 W CROSSVILLE RD STE 216, ROSWELL, GA 30075-7515
(470) 349-8884
Mailing address
840 LOWERY RD, ROCKMART, GA 30153-3415
(770) 324-2058
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016467
GA
225200000X
Physical Therapy Assistant
Primary
PTA003868
GA
Other
Enumeration date
08/06/2019
Last updated
03/19/2026
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