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Individual

CHRISTINE MARIE JOHNSON WEBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4175 VINEWOOD LN N, PLYMOUTH, MN 55442-2624
(763) 553-0302
Mailing address
9006 KAGAN AVE NE, OTSEGO, MN 55362-4535
(701) 200-9494

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120088
MN

Other

Enumeration date
07/06/2011
Last updated
07/06/2011
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