| NPI | 1619107943 |
|---|---|
| Former Name | TRACY LYNN MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT.013193) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: PA PT019555) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: KY PT005460) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2013-12-31 |