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NPI 1932394467

NPI 1932394467 : THOMAS G STENSLAND RPH : LOS LUNAS, NM

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General NPI Number Information
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    NPI Number           |    1932394467
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS G STENSLAND RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/07/2007
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    Last Update Date     |    09/07/2007
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Provider Practice Location Address
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    Address Line         |    2351 MAIN ST SE 
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    City                 |    LOS LUNAS
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    State                |    NM
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    Zip                  |    87031-6320
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    Country              |    US
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    Telephone            |    505-865-2089
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    Fax                  |    505-865-2829
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Provider Business Mailing Address
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    Address Line         |    2351 MAIN ST SE 
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    City                 |    LOS LUNAS
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    State                |    NM
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    Zip                  |    87031-6320
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    Country              |    US
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    Telephone            |    505-865-2089
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    Fax                  |    505-865-2829
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    RP00003844
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    License Number State |    NM
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