Individual
KIM MAXA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(615) 813-7259
Mailing address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122012
MN
183500000X
Pharmacist
8693621-1701
UT
183500000X
Pharmacist
RPH026631
GA
Other
Enumeration date
08/23/2014
Last updated
08/23/2014
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