Individual
BURTON GEORGE LADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1401 PAUL BUNYAN DR NW, BEMIDJI, MN 56601-4155
(218) 751-8178
Mailing address
4086 GRYCE STYNE RD NE, BEMIDJI, MN 56601-9875
(218) 586-3445
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112742
MN
183500000X
Pharmacist
3295
ND
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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