Provider Demographics
NPI:1770805970
Name:MOWERY, JOHN BOYD JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BOYD
Last Name:MOWERY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:201 CROSSINGS MALL RD
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-9230
Mailing Address - Country:US
Mailing Address - Phone:304-965-7261
Mailing Address - Fax:304-965-2424
Practice Address - Street 1:201 CROSSINGS MALL RD
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9230
Practice Address - Country:US
Practice Address - Phone:304-965-7261
Practice Address - Fax:304-965-2424
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVRP0005386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist