| Doctor Name: | LACEY MOODY |
| NPI Number: | 1083025001 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PT5426 |
| Business Practice Address: | 3964 Goodman Rd E Suite 111 Southaven, MS - 386728761 |
| Business Phone Number: | 6628906953 |
| Business Fax Number: | 6628906954 |
| Mailing Address: | 2001 Mallory Ln, Suite 201 FRANKLIN |
| State: | TN |
| Postal Code: | 370678233 |
| Phone Number: | 6153731350 |
| Fax Number: | 6152219054 |
| NPI Enumeration Date: | 05/13/2014 |
| NPI Last Update Date: | 05/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT5426 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |