Individual
ALLIE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6239 E BROWN RD STE 113, MESA, AZ 85205-4933
(480) 318-0663
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6241
(618) 462-9818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2621
AZ
Other
Enumeration date
07/26/2022
Last updated
08/23/2022
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