Individual
JOBETH LANELL MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 EXECUTIVE AVE, 1C, CLARKSVILLE, TN 37042-1389
(931) 802-8872
Mailing address
245 EXECUTIVE AVE, 1C, CLARKSVILLE, TN 37042-1389
(931) 802-8872
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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