Individual
SUSAN ANN HEDEMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 30TH AVE S, MOORHEAD, MN 56560-4926
(218) 331-2668
Mailing address
700 30TH AVE S, MOORHEAD, MN 56560-4926
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
114657
MN
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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