Individual
DR. TERRA H. LIDDIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD
Contact information
Practice address
812 5TH ST, LAS VEGAS, NM 87701-4330
(505) 425-3770
Mailing address
812 5TH ST, LAS VEGAS, NM 87701-4330
(505) 425-3770
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PC00000096
NM
183500000X
Pharmacist
Primary
RP00005165
NM
Other
Enumeration date
08/31/2005
Last updated
09/20/2013
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