Individual
LESLIE WIEDLOCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1001 NEW MEXICO 528 SE, RIO RANCHO, NM 87124
(505) 896-2078
(505) 896-1167
Mailing address
1001 NEW MEXICO 528 SE, RIO RANCHO, NM 87124
(505) 896-2078
(505) 896-1167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007475
NM
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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