Individual
MICHAEL LIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
901 UNSER BLVD SE, RIO RANCHO, NM 87124-6365
(505) 962-9227
Mailing address
901 UNSER BLVD SE, RIO RANCHO, NM 87124-6365
(505) 962-9227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007534
NM
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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