Individual
KJERSHA LOUISE WANLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
105 S 1ST ST, OLIVIA, MN 56277-2442
(320) 523-2110
(320) 523-2113
Mailing address
105 S 1ST ST, OLIVIA, MN 56277-2442
(320) 523-2110
(320) 523-2113
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120329
MN
Other
Enumeration date
05/05/2018
Last updated
05/05/2018
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