Individual
DERRICK MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
208 8TH ST SW, ORANGE CITY, IA 51041-9022
(712) 707-7287
Mailing address
508 ZUIDER ZEE DR SE, ORANGE CITY, IA 51041-1764
(712) 441-4018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001063
IA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/21/2015
Last updated
04/18/2022
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