Individual
MR. DALE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 KANAWHA DR, WEIRTON, WV 26062-3917
(304) 670-4429
Mailing address
203 KANAWHA DR, WEIRTON, WV 26062-3917
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03223008
OH
183500000X
Pharmacist
Primary
RP0005657
WV
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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