Individual
MR. VERNON MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
109 KIOWA ST, MONROE, LA 71203-8565
(318) 557-1672
(318) 345-2862
Mailing address
109 KIOWA ST, MONROE, LA 71203-8565
(318) 557-1672
(318) 345-2862
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10600
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1434957
—
LA
Enumeration date
04/17/2007
Last updated
10/04/2011
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