Individual
SHONTAE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
979 N BLACK HORSE PIKE, WILLIAMSTOWN, NJ 08094-1044
(856) 629-5151
Mailing address
401 ROUTE 73 N BLDG 10, SUITE 320, MARLTON, NJ 08053
(856) 872-7055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00385300
NJ
363A00000X
Physician Assistant
MA056299
PA
Other
Enumeration date
11/12/2013
Last updated
12/20/2024
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