Individual
MACKENZIE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7971 S 44TH WEST AVE, TULSA, OK 74132-3466
(918) 557-7409
Mailing address
7971 S 44TH WEST AVE, TULSA, OK 74132-3466
(918) 557-7409
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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