Provider Demographics
NPI:1679537518
Name:MOSS, WILLIAM CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:MOSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:958 E MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2148
Mailing Address - Country:US
Mailing Address - Phone:864-542-0780
Mailing Address - Fax:864-542-1689
Practice Address - Street 1:945 EAST MAIN STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302
Practice Address - Country:US
Practice Address - Phone:864-542-0780
Practice Address - Fax:864-542-1689
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2834Medicaid
SCCH2834Medicaid
SC8937Medicare PIN