Individual
PAUL R BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
955 S 2ND ST, RATON, NM 87740-2301
(575) 445-3131
(575) 445-5393
Mailing address
955 S 2ND ST, RATON, NM 87740-2301
(575) 445-3131
(575) 445-5393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00005738
NM
Other
Enumeration date
10/03/2011
Last updated
09/20/2017
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