Provider Demographics
NPI:1386053494
Name:MOSS, ERIN (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MOSS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 GUM BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-8227
Mailing Address - Country:US
Mailing Address - Phone:910-430-2201
Mailing Address - Fax:910-430-4325
Practice Address - Street 1:7011 GUM BRANCH RD
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28574-8227
Practice Address - Country:US
Practice Address - Phone:910-430-2201
Practice Address - Fax:910-430-4325
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP15071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP15071OtherNCPTA