Individual
MALLORY BROOKE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4772 NAVY RD STE A, MILLINGTON, TN 38053-1957
(901) 873-0930
Mailing address
4772 NAVY RD STE A, MILLINGTON, TN 38053-1957
(901) 873-0930
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
07/23/2024
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