Individual
LADAWNA CAMILE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
42121 US HIGHWAY 70, PORTALES, NM 88130-9054
(575) 356-3456
Mailing address
510 BROADMOOR ACRES, PORTALES, NM 88130-9327
(575) 760-0993
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006114
NM
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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