Individual
AMANDA JO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
400 S STATE ST STE 50, FAIRMONT, MN 56031-2872
(507) 238-2797
Mailing address
308 STADE LN, FAIRMONT, MN 56031-3253
(507) 236-8278
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121228
MN
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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