Organization
DAHLSTROMS INC
Active
Other names
lakeside market
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN O DAHLSTROM (PRESIDENT)
(715) 468-2319
Entity
Organization
Contact information
Practice address
37 5TH AVE, SHELL LAKE, WI 54871-0236
(715) 468-2319
(715) 468-4140
Mailing address
37 5TH AVE, PO BOX 236, SHELL LAKE, WI 54871
(715) 468-2319
(715) 468-4140
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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