Individual
ELIJAH CALE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5119 CITY STATION DR, COLLEGE DALE, TN 37363-7153
(762) 294-0290
Mailing address
5119 CITY STATION DR, COLLEGE DALE, TN 37363-7153
(762) 294-0290
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TN
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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