Individual
MR. GONZALUS ORELL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
13939 LIVERNOIS AVE, DETROIT, MI 48238-2519
(313) 934-0150
(313) 491-1831
Mailing address
13939 LIVERNOIS AVE, DETROIT, MI 48238-2519
(313) 934-0150
(313) 491-1831
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302410366
MI
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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