Individual
CASEY CHARLES HALCROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2643 CENTRAL AVE NE, MINNEAPOLIS, MN 55418-2910
(612) 789-6251
Mailing address
2643 CENTRAL AVE NE, MINNEAPOLIS, MN 55418-2910
(612) 789-6251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120019
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120019
MINNESOTA PHARMACIST LICENSE
MN
Enumeration date
12/02/2011
Last updated
12/02/2011
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