Individual
JESSICA DESANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
571 WALTON BLVD, LAS CRUCES, NM 88001-8449
(575) 524-3501
Mailing address
571 WALTON BLVD, LAS CRUCES, NM 88001-8449
(575) 524-3501
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008839
NM
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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