Individual
MR. JONATHAN MAURICE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7512 BOYDTON PLANK RD, NORTH DINWIDDIE, VA 23803-7354
(804) 943-1549
Mailing address
7512 BOYDTON PLANK RD, NORTH DINWIDDIE, VA 23803-7354
(804) 943-1549
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
VA
Other
Enumeration date
08/10/2017
Last updated
06/16/2018
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