Individual
MR. EVAN S MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
174 MAIN ST, PEABODY, MA 01960-5644
(978) 977-4844
Mailing address
58 FRIEND ST APT 1, GLOUCESTER, MA 01930-3291
(978) 412-5749
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT24422
MA
Other
Enumeration date
08/15/2020
Last updated
11/16/2020
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