Moise Kelly

NPI 1447640958 · on the registry since 2015 · sole proprietor

Practice

Address: 455 S Mesa Dr Unit 142
Mesa, AZ 85210
Phone: (480) 277-0313
Organisation at this address: Seeds Of Gaia Llc
Seeds Of Gaia Llc
Dash Transport Services Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 172V00000X
172V00000X
Also registered as: 101Y00000X
104100000X
171M00000X
174H00000X
Licence states on file: AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2019-07-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona