Provider Demographics
NPI:1407153729
Name:MOSS, TIMOTHY CRAFT (CFTS)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CRAFT
Last Name:MOSS
Suffix:
Gender:M
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-3407
Mailing Address - Country:US
Mailing Address - Phone:704-435-6011
Mailing Address - Fax:704-435-1966
Practice Address - Street 1:100 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-3407
Practice Address - Country:US
Practice Address - Phone:704-435-6011
Practice Address - Fax:704-435-1966
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000823532I225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter