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General NPI Number Information
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NPI Number | 1598605784
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Entity Type | Organization
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Legal Business Name | MOODY CHIROPRACTIC GROUP LLC
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 2963 GULF TO BAY BLVD STE 206
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City | CLEARWATER
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State | FL
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Zip | 33759-4200
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Country | US
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Telephone | 402-415-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 FLOURNOY CIR W APT 10117
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City | CLEARWATER
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State | FL
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Zip | 33764-1409
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Country | US
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Telephone | 402-415-3661
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ANTHONY JUSTIN MOODY
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Credential | DC
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Telephone | 402-415-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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