Individual
LORI BOMMERSBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
1395 S COLUMBIA RD, SUITE C, GRAND FORKS, ND 58201-4054
(701) 746-1800
(701) 074-6404
Mailing address
2622 S 18TH ST, GRAND FORKS, ND 58201-6629
(701) 795-8565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
114351
MN
183500000X
Pharmacist
Primary
4118
ND
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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