Individual
SUSAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2513 MAPLE POINT DR, LAFAYETTE, IN 47905-5157
(765) 447-8337
Mailing address
2513 MAPLE POINT DR, LAFAYETTE, IN 47905-5157
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021122A
IN
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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