Individual
MARVIN LEROY DYRSTAD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
910 W 6TH ST, RED WING, MN 55066-2432
(651) 388-6883
(651) 388-6796
Mailing address
910 W 6TH ST, RED WING, MN 55066-2432
(651) 388-6883
(651) 388-6796
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
110761-4
MN
Other
Enumeration date
07/22/2005
Last updated
07/08/2007
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