Individual
MARK DOUGLAS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
5200 FAIRVIEW BLVD, PHARMACY, WYOMING, MN 55092-8013
(651) 982-7237
(651) 982-7236
Mailing address
670 MINDY CRK, SAINT CROIX FALLS, WI 54024-9413
(715) 483-3152
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112843-1
MN
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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