DR. Ivy D Moore, PD

NPI #1194943225 in Magnolia, Arkansas

Provider Information

NPI Number: 1194943225
Entity Type: Individual
Name: DR. Ivy D Moore, PD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PD
Enumeration Date: Apr 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 134 N WASHINGTON
City: Magnolia
State: Arkansas
ZIP Code: 71753-2856
Phone: (870) 234-1062

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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