Individual
SYLVIA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-7250
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-7250
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202213653
VA
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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