Individual
JACK THOMAS MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
PHS INDIAN HEALTH SERVICE, 40520 CO. HWY 34, OGEMA, MN 56569
(218) 983-6375
(218) 983-6384
Mailing address
15374 SUNSET HILL DR, DETROIT LAKES, MN 56501-7125
(218) 847-9183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4822
ND
Other
Enumeration date
04/03/2007
Last updated
11/08/2007
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