Individual
DR. JASON MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1920 BUERKLE RD, WHITE BEAR LAKE, MN 55110-1300
(651) 777-2350
(651) 777-2537
Mailing address
2208 4TH ST E, SAINT PAUL, MN 55119-4012
(651) 408-4855
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126136
MN
Other
Enumeration date
07/31/2023
Last updated
08/24/2023
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