Individual
JEANANN DAWN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1500 E SHERIDAN ST, ELY, MN 55731-1855
(218) 365-7123
(281) 365-7124
Mailing address
1500 E SHERIDAN ST, ELY, MN 55731-1855
(218) 365-7123
(218) 365-7124
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113338
MN
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
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