Individual
JASON DALE KINYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1185
Mailing address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1185
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19732
MD
183500000X
Pharmacist
Primary
RP00007564
NM
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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