IndividualActive
Kenneth Moss, C.S.A.
NPI 1205950680 · Surgical Technologist · Loganville, GA
Provider details
- NPI number
- 1205950680
- Entity type
- Individual
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Credential
- C.S.A.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1558 (GA)
Practice location
2602 Fall Creek Ldg
Loganville, GA 30052-5877
Phone: (404) 310-2321
Fax: (404) 985-1694
Mailing address
Po Box 888235
Atlanta, GA 30356-0235
Registry dates
- Enumerated
- 2007-03-19
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.