Individual
LISA BULLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
17 DIVISION ST, WAITE PARK, MN 56387-1349
(320) 203-1035
Mailing address
17 DIVISION ST, WAITE PARK, MN 56387-1349
(320) 203-1035
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120463
MN
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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