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1083025001
LACEY MOODY
SOUTHAVEN, MS
NPI
1083025001
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MS PT5426)
Enumeration Date
2014-05-13
Last Update Date
2014-05-13
Business Address
LACEY MOODY
3964 GOODMAN RD E SUITE 111
SOUTHAVEN, MS 38672-8761
Phone number: 662-890-6953
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Mailing Address
LACEY MOODY
2001 MALLORY LN SUITE 201
FRANKLIN, TN 37067-8233
Phone number: 615-373-1350
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