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General NPI Number Information
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NPI Number | 1457114357
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Entity Type | Individual
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Provider Name | LEAH MOSS DC
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Gender | Female
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 3200 4TH ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33704-2157
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Country | US
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Telephone | 662-436-4161
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Fax |
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Provider Business Mailing Address
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Address Line | 7763 RIDGELAKE CIR
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City | BRADENTON
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State | FL
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Zip | 34203-2510
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Country | US
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Telephone | 321-696-9462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14876
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License Number State | FL
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