Randolph Mattila

NPI #1740680099 in Grants, New Mexico

Provider Information

NPI Number: 1740680099
Entity Type: Individual
Name: Randolph Mattila
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 23, 2014
Last Updated: Aug 23, 2014

Practice Location

Address: 1208 BONITA ST
City: Grants
State: New Mexico
ZIP Code: 87020-2234
Phone: (505) 287-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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