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General NPI Number Information
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NPI Number | 1396845855
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Entity Type | Individual
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Provider Name | DAVID JOHN MOOK R PH
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 100 FORT JEFFERSON AVE
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City | GREENVILLE
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State | OH
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Zip | 45331
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Country | US
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Telephone | 937-547-1642
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Fax | 937-547-2292
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Provider Business Mailing Address
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Address Line | 6608 STAHL RD
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City | GREENVILLE
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State | OH
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Zip | 45331-9217
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Country | US
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Telephone | 937-548-9054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-20604
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License Number State | OH
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