Individual
MRS. CLALIEN MARIE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
40 2ND ST S, WAITE PARK, MN 56387-1300
(320) 251-3069
(320) 202-9308
Mailing address
40 2ND ST S, WAITE PARK, MN 56387-1300
(320) 251-3069
(320) 202-9308
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
114745
MN
183500000X
Pharmacist
4285
ND
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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