Individual
SHANNON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 26TH AVE S, MINNEAPOLIS, MN 55406-4129
(612) 721-5840
(612) 721-2718
Mailing address
2211 E 24TH ST, MINNEAPOLIS, MN 55404-4113
(856) 375-4406
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126345
MN
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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