Individual
GEORGE MOYA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 MAIN ST NW, LOS LUNAS, NM 87031-4807
(505) 565-4622
(505) 565-4625
Mailing address
2250 MAIN ST NW, LOS LUNAS, NM 87031-4807
(505) 565-4622
(505) 565-4625
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5356
NM
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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