Individual
NAM VO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
548 S MARINE CORPS DR, TAMUNING, GU 96913-3539
(671) 646-5825
(671) 647-3598
Mailing address
548 S MARINE CORPS DR, TAMUNING, GU 96913-3539
(671) 646-5825
(671) 647-3598
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH0229
GU
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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