Individual
MR. JERRY RAY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RD, CNSD
Contact information
Practice address
12647 OLIVE BLVD STE 600, SAINT LOUIS, MO 63141-6346
(800) 325-3982
Mailing address
4008 NORDLAND TRL, CASTLE ROCK, CO 80109-7937
(303) 814-1511
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-593
ID
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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