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1629577549
JORDAN MOODY
COLUMBIA, SC
NPI
1629577549
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2083S0010X Preventive Medicine, Sports Medicine
(Licence: SC SC500634)
Enumeration Date
2018-02-06
Last Update Date
2018-02-06
Business Address
JORDAN MOODY
811 POLO RD APT 616
COLUMBIA, SC 29223-4445
Phone number: 803-586-2132
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Mailing Address
JORDAN MOODY
811 POLO RD APT 616
COLUMBIA, SC 29223-4445
Phone number: 803-586-2132
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