Individual
MR. MICHAEL RAY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
179 KENT ST, BROOKLINE, MA 02446-5463
(617) 299-9131
Mailing address
179 KENT ST, BROOKLINE, MA 02446-5463
(617) 299-9131
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
39282
TN
183700000X
Pharmacy Technician
Primary
PHA-PTE-LIC-83395
MT
183700000X
Pharmacy Technician
VA61082215
WA
Other
Enumeration date
10/22/2020
Last updated
06/26/2024
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