THAD A KOPPENHAFER

SHIPROCK, NM
NPI1780675371
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: CO  15373)
Enumeration Date2005-11-02
Last Update Date2008-02-08
Business Address
-- THAD A KOPPENHAFER PharmD
US HWY 491 N
SHIPROCK, NM 87420
Phone number: 505-368-6401
Mailing Address
-- THAD A KOPPENHAFER PharmD
PO BOX 160
SHIPROCK, NM 87420-0160
Phone number: 505-368-6401
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