Individual
DR. IVY D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PD
Contact information
Practice address
134 N WASHINGTON, MAGNOLIA, AR 71753-2856
(870) 234-1062
Mailing address
P.O. BOX 597, MAGNOLIA, AR 71754
(870) 234-1062
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD07920
AR
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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