Provider Information for 1760621403
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PHILIP MOSS MA, LPC
Sex: Male
NPI: 1760621403
Last Updated: 2009-02-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1760621403 | ||||||||
| Enumeration Date | 2009-02-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 211 W MAIN ST STERLING, CO 80751-3168 United States Phone: 970-522-4549 | Fax:970-522-4211 | ||||||||
| Primary Practice Address | 650 EAST WALNUT STERLING, CO 80751 United States Phone: 970-522-4549 | Fax:970-522-4211 | ||||||||
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