Individual
MR. RUSSELL T MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
339 9TH AVE SW, LAFAYETTE, AL 36862-2803
(334) 864-7781
(334) 864-0096
Mailing address
339 9TH AVE SW, LAFAYETTE, AL 36862-2803
(334) 864-7781
(334) 864-0096
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14177
AL
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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