Individual
RANDY T NICOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
RIVERWOOD HEALTHCARE CENTER, 200 BUNKER HILL DRIVE, AITKIN, MN 56431-1865
(218) 927-5588
Mailing address
6194 FAIRFAX CT, BAXTER, MN 56425-8733
(218) 829-1986
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113321
MN
Other
Enumeration date
04/18/2007
Last updated
12/18/2010
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