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Individual

DR. JESSICA R BONIFAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
851 MARKETPLACE DR, WACONIA, MN 55387-1548
(952) 442-4407
(952) 442-5787
Mailing address
851 MARKETPLACE DR, WACONIA, MN 55387-1548
(952) 442-4407
(952) 442-5787

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118050-5
MN

Other

Enumeration date
07/07/2005
Last updated
07/10/2010
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