| Jemicah Mosby, | |
|
385 Sablewood Dr, Milton, GA 30004-8048 | |
| (770) 377-7633 | |
| Not Available |
| Full Name | Jemicah Mosby |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 385 Sablewood Dr, Milton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194480764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 004956 (Georgia) | Primary |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1528419751 PECOS PAC ID: 2163339722 Enrollment ID: O20160830000411 |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1831619337 PECOS PAC ID: 2163339722 Enrollment ID: O20220916001457 |
| Mailing Address | Practice Location Address |
|---|---|
| Jemicah Mosby, 385 Sablewood Dr, Milton, GA 30004-8048 Ph: (770) 377-7633 | Jemicah Mosby, 385 Sablewood Dr, Milton, GA 30004-8048 Ph: (770) 377-7633 |
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