Individual
MR. SHANE WILTON WOOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8011 HARPER DR NE, ALBUQUERQUE, NM 87111-1054
(505) 217-2392
Mailing address
7428 EAGLE CREST AVE NE, ALBUQUERQUE, NM 87113-2187
(505) 385-5885
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006786
NM
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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