Individual
JUSTIN KOTOBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8100 WYOMING BLVD NE, ALBUQUERQUE, NM 87113-1946
(505) 857-9783
Mailing address
9215 BLACK FARM LN NW, ALBUQUERQUE, NM 87114-5957
(505) 977-8962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00000106
NM
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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