Individual
LISA THELEN-BACHMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2855 CAMPUS DR, SUITE 180, PLYMOUTH, MN 55441-2649
(763) 577-7007
(763) 577-7196
Mailing address
17440 91ST AVE N, MAPLE GROVE, MN 55311-5404
(763) 420-9672
(763) 577-7007
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
114124
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
984660300
—
MN
Enumeration date
03/02/2009
Last updated
03/02/2009
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