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Individual

PATRICK SETH MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
220 E CRESTWOOD CT, GALLUP, NM 87301-7120
(910) 890-1955
Mailing address
220 E CRESTWOOD CT, GALLUP, NM 87301-7120
(910) 890-1955

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19180
NC

Other

Enumeration date
03/19/2008
Last updated
03/19/2008
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