Individual
JOSHUA MARK MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1145
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45836
SANFORD
SD
01
—
4994488
BCBS
—
05
—
5835000
—
SD
01
—
P00278968
MEDICARE RAILROAD
SD
01
—
PT1145
DAKOTACARE
SD
Enumeration date
03/10/2006
Last updated
11/16/2012
Update your record
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