Individual
JAMES G DERIFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
102 5TH AVE. NO, SO.ST.PAUL, MN 55075
(651) 455-4140
Mailing address
102 5TH AVENUE SO., SO.ST.PAUL, MN 55075
(651) 455-4140
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111151
MN
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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