Individual
MR. ISHAM RICKY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4051 SOUTHERN BLVD SE, RIO RANCHO, NM 87124-2069
(505) 892-6690
Mailing address
4051 SOUTHERN BLVD SE, RIO RANCHO, NM 87124-2069
(505) 892-6690
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00005810
NM
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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