Individual
MRS. GEORGIA A HETLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
122 E KEMP, WATERTOWN, SD 57201-3640
(605) 882-4809
Mailing address
312 6TH AVE NW, WATERTOWN, SD 57201-2346
(605) 882-2842
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R4350
SD
Other
Enumeration date
10/14/2006
Last updated
07/08/2007
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