Individual
KOR MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 WHALON ST, FITCHBURG, MA 01420-7158
(978) 345-7540
Mailing address
44 HIGHLAND AVE, FITCHBURG, MA 01420-7815
(978) 870-5502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH233710
MA
Other
Enumeration date
06/23/2012
Last updated
06/23/2012
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