Individual
SAM MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
297 TERRELL LN, BARBOURVILLE, KY 40906-7862
(606) 546-9241
Mailing address
297 TERRELL LN, BARBOURVILLE, KY 40906-7862
(606) 546-9241
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012570
KY
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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