Individual
MOOCHAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
12401 PRINCESS JEANNE AVE NE, ALBUQUERQUE, NM 87112-4639
(505) 382-4904
Mailing address
12401 PRINCESS JEANNE AVE NE, ALBUQUERQUE, NM 87112-4639
(505) 382-4904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009544
NM
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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