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Individual

DOUGLAS KAASA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
1305 HIGHWAY 10 W, DETROIT LAKES, MN 56501-2214
(218) 847-9755
(847) 747-1701
Mailing address
1305 HIGHWAY 10 W, DETROIT LAKES, MN 56501-2214
(218) 847-9755
(847) 747-1701

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115112
MN
183500000X
Pharmacist
3549
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115112
MINNESOTA STATE PHARMACY LICENSE
MN
Enumeration date
03/31/2016
Last updated
03/31/2016
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