Individual
AMBER AXTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 209-1542
Mailing address
1425 MAIN ST N, PINE CITY, MN 55063-6026
(320) 322-5141
(320) 322-5132
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119447
MN
Other
Enumeration date
01/05/2019
Last updated
11/11/2020
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