Individual
MICHAEL UKESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
4445 NATHAN LN N, PLYMOUTH, MN 55442-4518
(763) 557-0377
Mailing address
6133 VIRGINIA AVE N, NEW HOPE, MN 55428-2738
(612) 508-9204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115704
MN
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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