Provider Demographics
NPI:1821688680
Name:MOSLEY, LLOYD
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5692 LASATER DR NW APT 17
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1918
Mailing Address - Country:US
Mailing Address - Phone:330-693-6398
Mailing Address - Fax:
Practice Address - Street 1:5692 LASATER DR NW APT 17
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-1918
Practice Address - Country:US
Practice Address - Phone:330-693-6398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant