Individual
JUSTIN RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5415 LYNDALE AVE S, MINNEAPOLIS, MN 55419-1717
(612) 824-1121
Mailing address
5930 RUSSELL AVE S, MINNEAPOLIS, MN 55410-2949
(952) 240-8003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118841
MN
Other
Enumeration date
07/05/2010
Last updated
07/05/2010
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