Individual
CHELSI MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
WALMART PHARMACY, 800 E MAIN ST, LOCUST GROVE, OK 74352
(918) 479-4815
Mailing address
123 N VANN ST, PRYOR, OK 74361-2423
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17044
OK
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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