Healthcare Provider Details

I. General information

NPI: 1942172762
Provider Name (Legal Business Name): MOXIE CREW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 REVOLUTION MILL DR STE 5
GREENSBORO NC
27405-5068
US

IV. Provider business mailing address

1101 SPY GLASS WAY
KNOXVILLE TN
37922-5244
US

V. Phone/Fax

Practice location:
  • Phone: 865-408-8423
  • Fax:
Mailing address:
  • Phone: 865-406-8979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL ARTHUR HIGLEY
Title or Position: PRESIDENT
Credential:
Phone: 865-406-8979