Most Relevant Information
Provider Data
| NPI Number: | 1003427220 |
| Provider Name: | LAUREN MICHELLE HERTZOG PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | P8892 |
Most Important Dates
| Enumeration Date: | 08/11/2020 |
| Last Updated: | 08/11/2020 |
Provider Practice Location
516 E NIZHONI BLVD
GALLUP
NM
873015748
Practice Location Phone/Fax
| Phone: | 5057221999 |
| Fax: |
Provider Mailing Location
134 LORI LN
MERTZTOWN
PA
195399123
Provider Mailing Phone/Fax
| Phone: | 4848929638 |
| Fax: |