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Individual

MR. BLAIN E. NYBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
9601 TOWNLINE RD, MINOCQUA, WI 54548-9099
(715) 358-1217
(715) 358-1183
Mailing address
9601 TOWNLINE RD, MINOCQUA, WI 54548-9099
(715) 358-1217
(715) 358-1183

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9584-040
WI

Other

Enumeration date
08/19/2006
Last updated
07/08/2007
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