Individual
LARRY WAYNE FANGSRUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3180 HWY 2 W, KMART PHARMACY, HAVRE, MT 59501
(406) 265-1854
(406) 265-4647
Mailing address
6962 1ST ST W, HAVRE, MT 59501-5702
(406) 265-2031
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2784
MT
Other
Enumeration date
01/13/2009
Last updated
01/13/2009
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