Provider Demographics
NPI:1790168003
Name:MOY, VICTORIA-LEE NGAR-YAN (DC, PHARMD)
Entity Type:Individual
Prefix:
First Name:VICTORIA-LEE
Middle Name:NGAR-YAN
Last Name:MOY
Suffix:
Gender:F
Credentials:DC, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3237 W TRUMAN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-6944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3237 W TRUMAN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6944
Practice Address - Country:US
Practice Address - Phone:573-635-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014041515183500000X
MO2023009810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No183500000XPharmacy Service ProvidersPharmacist