Provider Demographics
NPI:1740431675
Name:MOSER, SHERI DENISE
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:DENISE
Last Name:MOSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E RIO SALADO PKWY
Mailing Address - Street 2:SUITE 1066
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-4877
Mailing Address - Country:US
Mailing Address - Phone:480-921-0067
Mailing Address - Fax:480-993-2743
Practice Address - Street 1:2000 E RIO SALADO PKWY
Practice Address - Street 2:SUITE 1066
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-4877
Practice Address - Country:US
Practice Address - Phone:480-921-0067
Practice Address - Fax:480-993-2743
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2145I156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician