Individual
DEREK BENJAMIN TWITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 W ZIA RD, SANTA FE, NM 87505-6910
(505) 820-2196
Mailing address
525 W ZIA RD, SANTA FE, NM 87505-6910
(505) 820-2196
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007845
NM
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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