Individual
KIMBERLY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4588 N RANCHO DR, # 12, LAS VEGAS, NV 89130-3426
(702) 338-4697
(702) 396-6164
Mailing address
4160 S. PECOS ST 17, LAS VEGAS, NV 89121-5027
(702) 396-3464
(702) 396-6164
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/09/2010
Last updated
09/18/2012
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