Individual
RANDAL LYNN WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
710 PASEO DEL PUEBLO SUR STE A, TAOS, NM 87571-5998
(575) 758-1203
Mailing address
710 PASEO DEL PUEBLO SUR STE A, TAOS, NM 87571-5998
(575) 758-1203
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6805
NM
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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