Individual
COLTON MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 ATLANTA ST SE, GRAVETTE, AR 72736-9364
(479) 787-5966
Mailing address
15603 BIRD MOUNTAIN RD, SULPHUR SPRINGS, AR 72768-9091
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD13952
AR
Other
Enumeration date
11/15/2020
Last updated
11/15/2020
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