Individual
TINA SPARKS OVIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6775 YORK AVE S, EDINA, MN 55435-2514
(952) 925-3911
Mailing address
621 6TH AVE S, SOUTH ST PAUL, MN 55075-2833
(651) 249-4125
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116880
MN
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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