Individual
MR. TERRY MACK MOORE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
115 MEDICAL DR, GUYMON, OK 73942-3606
(580) 338-7565
(580) 338-7302
Mailing address
1307 N SUNSET LN, GUYMON, OK 73942-3142
(580) 338-7565
(580) 338-7302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8742
OK
Other
Enumeration date
11/04/2006
Last updated
04/01/2011
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