Provider Demographics
NPI:1215149380
Name:MORETZ, JONAS CLAYTON JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JONAS
Middle Name:CLAYTON
Last Name:MORETZ
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:3708 PINECREST DR NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-8741
Mailing Address - Country:US
Mailing Address - Phone:828-256-5189
Mailing Address - Fax:828-324-4630
Practice Address - Street 1:1501 TATE BLVD SE
Practice Address - Street 2:SUITE 102
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1384
Practice Address - Country:US
Practice Address - Phone:828-324-4630
Practice Address - Fax:828-324-4675
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC6050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist