Lacey Moody

NPI #1083025001 in Southaven, Mississippi

Provider Information

NPI Number: 1083025001
Entity Type: Individual
Name: Lacey Moody
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: May 13, 2014
Last Updated: May 13, 2014

Practice Location

Address: 3964 GOODMAN RD E
Address 2: SUITE 111
City: Southaven
State: Mississippi
ZIP Code: 38672-8761
Phone: (662) 890-6953

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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