Individual
VITALIYA PETKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2266 WYOMING BLVD NE, ALBUQUERQUE, NM 87112-2620
(595) 323-2885
Mailing address
5119 GLENWOOD POINTE LN NE, ALBUQUERQUE, NM 87111-2976
(505) 216-1731
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007537
NM
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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