Individual
JORDON WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9651 WYOMING TER S, BLOOMINGTON, MN 55438-1606
(612) 803-8537
Mailing address
9651 WYOMING TER S, BLOOMINGTON, MN 55438-1606
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120970
MN
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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