Individual
CHRISTOPHER MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
417 W 3RD AVE, ALBANY, GA 31701-1943
(229) 312-1000
Mailing address
539 N WESTOVER BLVD APT 926, ALBANY, GA 31707-7102
(803) 351-7058
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000037223
BOC CERTIFICATION NUMBER
SC
Enumeration date
07/26/2019
Last updated
07/26/2019
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