Individual
JEFFREY EDWARD MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
301 N BROADWAY ST, CLEVELAND, OK 74020-3421
(918) 358-2524
(918) 358-2588
Mailing address
301 N BROADWAY ST, CLEVELAND, OK 74020-3421
(918) 358-2524
(918) 358-2588
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10598
OK
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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