Individual
MICHAEL MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1291 LOMBARDI ACCESS RD, GREEN BAY, WI 54304-4046
(920) 498-9783
Mailing address
1291 LOMBARDI ACCESS RD, GREEN BAY, WI 54304-4046
(920) 498-9783
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17719-40
WI
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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