Individual
SAMANTHA ANN KETTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2475 32ND AVE S STE 1, GRAND FORKS, ND 58201-3606
(701) 775-4209
(701) 775-9122
Mailing address
1220 55TH AVE S APT 309, GRAND FORKS, ND 58201-9271
(218) 790-0492
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6046
ND
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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