Individual
MISS KELLEY MARIE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
750 W CAROLINA AVE, HARTSVILLE, SC 29550-4412
(843) 951-9990
(843) 951-9989
Mailing address
750 W CAROLINA AVE, HARTSVILLE, SC 29550-4412
(843) 995-9990
(843) 951-9989
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
23682
SC
Other
Enumeration date
02/17/2020
Last updated
02/08/2022
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