Individual
MR. BRANDON KENNETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
211 4TH ST, PHARMACY DEPARTMENT, ALEXANDRIA, LA 71301-8421
(318) 473-3065
Mailing address
105 NORTHVIEW DR, PINEVILLE, LA 71360-4684
(318) 473-4096
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17702
LA
Other
Enumeration date
05/06/2007
Last updated
07/08/2007
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