Individual
DICK JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
744 JEFFERSON ST S, SHAKOPEE, MN 55379-2047
(612) 462-4867
Mailing address
744 JEFFERSON ST S, SHAKOPEE, MN 55379-2047
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112330
MN
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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