Individual
MR. DANIEL FREDERICK BOHMER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3000 32ND AVE S, PHARMACY DEPARTMENT, FARGO, ND 58103-6132
(701) 364-8143
(701) 364-8157
Mailing address
515 30TH ST N, MOORHEAD, MN 56560-2561
(701) 388-5547
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
115414-6
MN
183500000X
Pharmacist
Primary
4495
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115414-6
PHARMACIST LICENSE
MN
01
—
4495
PHARMACIST LICENSE
ND
Enumeration date
02/06/2006
Last updated
07/08/2007
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