Individual
MRS. SANDY YVONNE MOODY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 COCHRANE CIR, FT CARSON, CO 80913-4603
(719) 524-4073
Mailing address
4736B BELCHER ST, COLORADO SPRINGS, CO 80913-1327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41744
CO
Other
Enumeration date
02/24/2006
Last updated
07/08/2007
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