Individual
AMY LU MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
254 MOSS D LANE, FAIRLEA, WV 24901
(304) 645-7364
Mailing address
PO BOX 204, RONCEVERTE, WV 24970-0204
(304) 645-7364
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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