Individual
ROBERT MOTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
366 MONTE VISTA RD, TAOS, NM 87571-6390
(575) 758-1476
Mailing address
366 MONTE VISTA RD, TAOS, NM 87571-6390
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007545
NM
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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