Individual
SHANNON KLOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
18275 KENRICK AVE, LAKEVILLE, MN 55044-7306
(952) 892-5400
Mailing address
18275 KENRICK AVE, LAKEVILLE, MN 55044-7306
(952) 892-5400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116046
MN
Other
Enumeration date
10/01/2011
Last updated
10/01/2011
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