Individual
TROY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
7101 WYOMING BLVD NE, ALBUQUERQUE, NM 87109-4868
(505) 821-1275
Mailing address
4904 OSUNA PL NE, ALBUQUERQUE, NM 87111-2531
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007864
NM
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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