Individual
JERRY PADILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 UNSER BLVD NW, ALBUQUERQUE, NM 87120-3889
(505) 217-9940
(505) 217-9996
Mailing address
2200 UNSER BLVD NW, ALBUQUERQUE, NM 87120-3889
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006085
NM
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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