Individual
CAROL RENEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2422 COLLEGE AVE, ALTON, IL 62002-4609
(618) 465-3434
Mailing address
2422 COLLEGE AVE, ALTON, IL 62002-4609
(618) 465-3434
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288330
IL
183500000X
Pharmacist
2012025456
MO
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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