Individual
MICHAEL DEAN FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
2140 S POKEGAMA AVE, GRAND RAPIDS, MN 55744-2507
(218) 326-6412
(218) 326-6412
Mailing address
2140 S POKEGAMA AVE, GRAND RAPIDS, MN 55744-2507
(218) 326-6412
(218) 326-6412
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
114352
MN
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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