Individual
JASON RYAN BOBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-7697
Mailing address
6308 ALPENGLOW TRL NE, ALBUQUERQUE, NM 87113-3401
(505) 239-7584
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RP00008913
NM
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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