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Individual

DR. MEGAN ANNE MATACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
701 PARK AVE, RL, MINNEAPOLIS, MN 55415-1623
(612) 873-9513
Mailing address
334 14TH AVE N, HOPKINS, MN 55343-7333
(612) 873-9513
(612) 904-4286

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118862
MN

Other

Enumeration date
05/16/2011
Last updated
05/16/2011
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