Individual
DR. JASON RYAN WACHTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., BCACP, CGP
Contact information
Practice address
10501 FLORIDA AVE S, BLOOMINGTON, MN 55438-2553
(952) 854-1190
(952) 854-1082
Mailing address
10501 FLORIDA AVE S, BLOOMINGTON, MN 55438-2553
(952) 854-1190
(952) 854-1082
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119029
MN
Other
Enumeration date
12/21/2008
Last updated
06/17/2014
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