Individual
MRS. KALLEY ANNE FAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1315 HIGHWAY 25 N, BUFFALO, MN 55313-1937
(763) 682-2963
Mailing address
1315 HIGHWAY 25 N, BUFFALO, MN 55313-1937
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
125353
MN
Other
Enumeration date
08/19/2021
Last updated
03/30/2023
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