Individual
MATTHEW E BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 PRINCETON DR SE APT C, ALBUQUERQUE, NM 87106-2898
(505) 903-2098
Mailing address
307 PRINCETON DR SE APT C, ALBUQUERQUE, NM 87106-2898
(505) 903-2098
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009389
NM
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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