Individual
THERESA DE JAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
2010 ADAMS ST, MANKATO, MN 56001-6817
(507) 625-7565
Mailing address
2010 ADAMS ST, MANKATO, MN 56001-6817
(507) 625-7565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123219
MN
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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