Basic Information
| Provider Information | |||||||||
| NPI: | 1437316973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOSER | ||||||||
| FirstName: | MARY | ||||||||
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| Credential: | CMF | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4321 WASHINGTON ST | ||||||||
| Address2: | SUITE 4000 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641115961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169324549 | ||||||||
| FaxNumber: | 8169329865 | ||||||||
| Practice Location | |||||||||
| Address1: | 4321 WASHINGTON ST | ||||||||
| Address2: | SUITE 4000 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641115961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169324549 | ||||||||
| FaxNumber: | 8169329865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2008 | ||||||||
| LastUpdateDate: | 05/21/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225000000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotic Fitter |
No ID Information.