Individual
MR. ADAM JOSEPH MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7 DURELL DR, KANKAKEE, IL 60901-6001
(000) 000-0000
Mailing address
7 DURELL DR, KANKAKEE, IL 60901-6001
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
160006509
IL
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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