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Contact Information

STEPHANIE L MOODY, ATC/L
101 FAIRVIEW PARK DRIVE
DUBLIN, GA31021
 Phone: 478-272-7494
 Fax: 478-272-2616
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for STEPHANIE L MOODY · (Female)

NPI # 1649364209
Status Active
Credentials ATC/L
Entity Individual
Enumeration date 10/03/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • GA License # AT000957
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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