Individual
SUSAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
326 W LINCOLN AVE, FERGUS FALLS, MN 56537-2027
(218) 736-1028
Mailing address
326 W LINCOLN AVE, FERGUS FALLS, MN 56537-2027
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113841
MN
183500000X
Pharmacist
4079
ND
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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