Individual
KINGSLY FOMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4547 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3926
(612) 722-4249
Mailing address
1551 ALBEMARLE ST APT 301, SAINT PAUL, MN 55117-3809
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120170
MN
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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