Individual
MR. BRUCE R. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PPH
Contact information
Practice address
530 2ND ST, HUDSON, WI 54016-1512
(715) 386-3344
(715) 386-5198
Mailing address
2161 HERON AVE N, OAKDALE, MN 55128-5314
(651) 773-0634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11051-040
WI
183500000X
Pharmacist
114361-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33003000
—
WI
01
—
5106275
NAPB
WI
Enumeration date
01/05/2007
Last updated
03/07/2023
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