Individual
TANYA SIVERTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 MADISON AVE, MANKATO, MN 56001-6883
(507) 625-1241
Mailing address
1800 MADISON AVE, MANKATO, MN 56001-6883
(507) 625-1241
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
MN117664
MN
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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