Individual
BARBAR AMALIA COLAIANNI-WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1870 E HIGHWAY 66, GALLUP, NM 87301-4955
(702) 275-9011
Mailing address
300 E HILL AVE, GALLUP, NM 87301-6155
(702) 275-9011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15066
NV
Other
Enumeration date
11/09/2011
Last updated
08/26/2013
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