Individual
SAMANTHA ANNE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
601 JACOB LN, ANOKA, MN 55303-1776
(763) 421-5540
Mailing address
601 JACOB LN, ANOKA, MN 55303-1776
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124755
MN
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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