Organization · Type 2 NPI
Moss Street Medical Clinic Inc
Medical Physician Assistant · Lafayette, LA
NPI number
1417085192
Active
Practice location
1417 Moss St
Lafayette, LA 70501-3654
Fax (337) 232-3511
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | A10226 (LA) |
Medical Physician Assistant: Definition to come...
About NPI 1417085192
Moss Street Medical Clinic Inc's National Provider Identifier is 1417085192, issued on Mar 2, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lafayette, LA. The record was last updated on Aug 22, 2020.