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Individual

ALICIA MARIE MOOTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1465 JOHNSTON WILLIS DR, RICHMOND, VA 23235-2323
(804) 320-3668
Mailing address
1465 JOHNSTON WILLIS DR, RICHMOND, VA 23235-2369
(804) 320-3668

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103301334
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006944
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/18/2018
Last updated
03/17/2025
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