Individual
MR. JOHNNY ALLEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
4715 NINE MILE RD, RICHMOND, VA 23223-4908
(804) 822-2057
Mailing address
4715 NINE MILE RD, RICHMOND, VA 23223-4908
(804) 822-2057
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
02004479
VA
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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