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Individual

JOHN PHILLIP MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
249 N DOUGLAS BLVD, MIDWEST CITY, OK 73130-3309
(405) 741-4411
Mailing address
11120 SE 49TH ST, OKLAHOMA CITY, OK 73150-3901

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8916
OK

Other

Enumeration date
12/04/2006
Last updated
07/08/2007
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