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CARLY JOHNS MOODY

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1316421647

Individual Registrant:
 CARLY JOHNS MOODY 
Gender: F
Sole Proprietor

Location and contact information for practice:
317 MADISON ST  SHERIDAN, MT 59749-9636 US
Tel: 406-842-7434  Fax: --

Contact information for business:
317 MADISON ST  SHERIDAN, MT 59749-9636 US
Tel: --  Fax: --

Registration Information:
NPI: 1316421647
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MTPHA-PHA-LIC-54887

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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