Individual
CHAD GARY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(801) 462-5485
Mailing address
15898 MARCELLO CIR, NAPLES, FL 34110-2832
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
125899
FL
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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