Individual
MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7107 CHARLESTON HWY, BOWMAN, SC 29018
(803) 829-2547
Mailing address
4257 HERITAGE HWY, BAMBERG, SC 29003-9199
(803) 245-0920
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
10119
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10119
PHARMACY TECH ID
SC
Enumeration date
11/14/2006
Last updated
07/08/2007
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