| NPI | 1831194778 |
|---|---|
| Former Name | STACY L MOSES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3627) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 6079) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-09 |