Individual
LARRY BERNARD TEBBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3601 HIGHWAY 100 S, ST LOUIS PARK, MN 55416-2500
(952) 926-8967
Mailing address
17731 DUCK LAKE TRL, EDEN PRAIRIE, MN 55346-3511
(952) 934-2203
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111818
MN
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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