| NPI | 1457414609 |
|---|---|
| Former Name | JENNIFER A MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6348) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 11773) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2014-05-27 |