Roger Nicolaus

NPI #1124435417 in Grants, New Mexico

Provider Information

NPI Number: 1124435417
Entity Type: Individual
Name: Roger Nicolaus
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jul 17, 2014
Last Updated: Jul 17, 2014

Practice Location

Address: 1000 ROBERT RD
City: Grants
State: New Mexico
ZIP Code: 87020-4012
Phone: (505) 285-3378

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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