Individual
MS. JEAN L DUTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
318 ABALONE LOOP, MESCALERO LUDIAN HOSPITAL, MESCALERO, NM 88340-0210
(505) 464-4441
(505) 464-4422
Mailing address
3727 DRIFTWOOD AVE, ALAMOGORDO, NM 88310-3727
(505) 437-6162
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
029534
MO
183500000X
Pharmacist
Primary
4480
NM
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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