Individual
FONDA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FON TRANS
Contact information
Practice address
50 HARBOR OAKS CV, OAKLAND, TN 38060-6069
(901) 355-4258
Mailing address
50 HARBOR OAKS CV, OAKLAND, TN 38060-6069
(901) 355-4258
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
172A00000X
Driver
—
—
347C00000X
Private Vehicle
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/14/2016
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