Individual
JOHN MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9134 CENTRAL AVE SE, ALBUQUERQUE, NM 87123-2510
(505) 299-6169
(505) 296-8859
Mailing address
9134 CENTRAL AVE SE, ALBUQUERQUE, NM 87123-2510
(505) 299-6169
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008221
NM
Other
Enumeration date
08/07/2014
Last updated
04/09/2019
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