Individual
MR. ANIS BEN TAHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
122 W MADISON AVE, GRANTSBURG, WI 54840-7022
(612) 272-3750
Mailing address
11461 N SHORE DR, GRANTSBURG, WI 54840-8059
(612) 272-3750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120871
MN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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