Individual
JACINTA CANDELARIA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 MAIN ST, ALAMOSA, CO 81101-2120
(719) 587-3076
Mailing address
1301 MAIN ST, ALAMOSA, CO 81101-2120
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0021907
CO
Other
Enumeration date
11/18/2017
Last updated
11/18/2017
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