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Individual

MRS. LORI ALISON AUTREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
111 WEST BROADWAY, MOUNTAINAIR, NM 87036
(505) 847-0242
(505) 847-0252
Mailing address
PO BOX 969, 111 W, BROADWAY, MOUNTAINAIR, NM 87036-0969
(505) 847-0242
(505) 847-0252

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH00006163
NM

Other

Enumeration date
12/24/2007
Last updated
12/24/2007
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