Individual
MARK CHARLES CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
415 JEFFERSON ST N, WADENA, MN 56482-1264
(218) 631-7476
Mailing address
415 JEFFERSON ST N, WADENA, MN 56482-1264
(218) 631-7476
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119289
MN
Other
Enumeration date
09/08/2008
Last updated
12/28/2016
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