Individual
DOUG WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3550 VICKSBURG LN N, PLYMOUTH, MN 55447-1322
(763) 553-2627
Mailing address
5556 BASSWOOD CIR, ROCKFORD, MN 55373-9651
(763) 477-6173
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111597
MN
Other
Enumeration date
05/26/2007
Last updated
07/08/2007
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