Individual
GAIL M. BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHC
Contact information
Practice address
454 SAINT MICHAELS DR, SANTA FE, NM 87505-7602
(505) 303-5000
Mailing address
157 ANYA RD, CORRALES, NM 87048-8582
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006061
NM
Other
Enumeration date
11/01/2006
Last updated
11/10/2020
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