Individual
CRYSTAL MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10000 COLUMBIA AVE, MUNSTER, IN 46321-4041
(219) 934-0750
Mailing address
3691 BALDWIN ST, PORTAGE, IN 46368-3156
(121) 950-8515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004884A
IN
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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