Individual
DEVAN J FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5757 HARPER DR NE, ALBUQUERQUE, NM 87109-3566
(505) 888-5757
Mailing address
5757 HARPER DR NE, ALBUQUERQUE, NM 87109-3566
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-2023-0006
NM
Other
Enumeration date
08/09/2023
Last updated
10/22/2024
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