Individual
MARK BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3913 W OLD SHAKOPEE RD, BLOOMINGTON, MN 55437-2944
(952) 252-1062
Mailing address
3913 W OLD SHAKOPEE RD, BLOOMINGTON, MN 55437-2944
(952) 252-1062
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19470-40
WI
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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