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Individual

JACQUELINE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10501 FLORIDA AVE S, BLOOMINGTON, MN 55438-2553
(952) 854-1190
Mailing address
10420 MARYLAND AVE N, BROOKLYN PARK, MN 55445-3278

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122227
MN
183500000X
Pharmacist
6272
SD

Other

Enumeration date
06/08/2015
Last updated
06/12/2020
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