Individual
DR. ROGER MARVIN ALLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1170 HWY 170, LA PLATA, NM 87418-0269
(505) 325-2472
Mailing address
PO BOX 269, LA PLATA, NM 87418-0269
(505) 325-2472
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2219 OP
NM
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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