Individual
COLLIN MOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5610 CENTENNIAL CENTER BLVD, LAS VEGAS, NV 89149-7104
(702) 395-3282
Mailing address
6525 SIERRA DIABLO AVE, LAS VEGAS, NV 89130-1869
(702) 449-4219
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
20726
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4276513
WALGREENS PHARMACY
—
Enumeration date
05/07/2021
Last updated
05/07/2021
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