Provider Demographics
NPI:1063865475
Name:MOYER, JODY LYNN (MS, RCEP, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:MOYER
Suffix:
Gender:F
Credentials:MS, RCEP, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BONNIEFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7825
Mailing Address - Country:US
Mailing Address - Phone:717-334-8786
Mailing Address - Fax:
Practice Address - Street 1:300 HIGHLAND AVENUE
Practice Address - Street 2:HANOVER HOSPITAL
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-316-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART002483A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer