Individual
ROBERT MARION ADDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHC
Contact information
Practice address
42121 US HWY 70, PORTALES, NM 88130-0510
(505) 356-6652
(505) 359-6827
Mailing address
PO BOX 550, FORT SUMNER, NM 88119-0550
(505) 355-7357
(505) 355-7816
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PC00000015
NM
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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