Individual
CODY KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-5836
(505) 877-3130
Mailing address
3401 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-5836
(505) 877-3130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009033
NM
Other
Enumeration date
03/27/2019
Last updated
04/23/2024
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