Individual
MISS VICKI L BRODSHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
MC BOX #366, FARGO, ND 58107-9983
(701) 280-4468
Mailing address
4527 4TH ST S, MOORHEAD, MN 56560-6745
(701) 306-5883
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3909
ND
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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