Individual
JIM MAHOWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
220 12TH AVE S, SARTELL, MN 56377-4624
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115862
MN
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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