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Individual

MRS. AMY JO MOODY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1604 MERRILL DR, LITTLE ROCK, AR 72211-1818
(501) 217-4995
Mailing address
605 RICHARDSON ST, BALD KNOB, AR 72010-3071
(501) 388-3067

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2575
AR

Other

Enumeration date
01/20/2012
Last updated
01/20/2012
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