Provider Demographics
NPI:1902344286
Name:MOSER, AMY (MSACN, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MOSER
Suffix:
Gender:F
Credentials:MSACN, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4002
Mailing Address - Country:US
Mailing Address - Phone:864-231-2000
Mailing Address - Fax:
Practice Address - Street 1:316 BOULEVARD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4002
Practice Address - Country:US
Practice Address - Phone:864-231-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAT034032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer