Individual
DANIEL JOSEPH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2700 NEW PINERY RD, PORTAGE, WI 53901-9221
(608) 742-5727
Mailing address
N55W34835 LAKE DR, OCONOMOWOC, WI 53066-2469
(262) 408-8956
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17086-40
WI
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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