Individual
RYAN LEE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 W 5TH ST, STARBUCK, MN 56381-2426
(320) 875-2052
Mailing address
1260 70TH ST SE, MURDOCK, MN 56271-7924
(320) 875-2052
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
711229-2
MN
Other
Enumeration date
06/22/2005
Last updated
07/08/2007
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