Individual
JASON CARROLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20715 GEMINI TRL, LAKEVILLE, MN 55044
(952) 432-5557
(952) 891-3512
Mailing address
20715 GEMINI TRL, LAKEVILLE, MN 55044-2514
(952) 432-5557
(952) 891-3512
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117875
MN
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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