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General NPI Number Information
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NPI Number | 1790168003
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Entity Type | Individual
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Provider Name | VICTORIA-LEE NGAR-YAN MOY DC, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 3237 W TRUMAN BLVD STE 100
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-6944
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Country | US
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Telephone | 573-635-0062
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Fax |
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Provider Business Mailing Address
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Address Line | 3237 W TRUMAN BLVD STE 100
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-6944
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Country | US
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Telephone |
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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 | 2014041515
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2023009810
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License Number State | MO
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