Individual
RENU BALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 B AVE, ZUNI, NM 87327
(505) 782-4431
Mailing address
PO BOX 978, ZUNI, NM 87327-0978
(469) 767-2781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202216043
VA
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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