Individual
STEPHEN DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31419 131ST STREET, PRINCETON, MN 55371
(763) 220-9227
Mailing address
31419 131ST ST, PRINCETON, MN 55371-9101
(763) 389-0944
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
116482
MN
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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