Individual
PAUL CONRAD ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
183500000X
Contact information
Practice address
117 MAIN AVE E, DEER RIVER, MN 56636-8735
(218) 246-8642
Mailing address
117 MAIN AVE E, DEER RIVER, MN 56636-8735
(218) 246-8642
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
109635
MN
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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