Individual
BIC T NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ROUTE 301 N 21 B AVENUE, ZUNI, NM 87327
(505) 782-7518
Mailing address
215 MAPLE AVE, GALLUP, NM 87301
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP00007214
NM
183500000X
Pharmacist
Primary
RP442968
PA
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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