Individual
GENA CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 14TH ST NE, EAST GRAND FORKS, MN 56721-1628
(218) 773-0611
Mailing address
224 14TH ST NE, EAST GRAND FORKS, MN 56721-1628
(218) 773-0611
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
126564
MN
183500000X
Pharmacist
Primary
RPH6605
ND
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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