Individual
JACOB STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
19216 FREEPORT AVE, CUB PHARMACY, ELK RIVER, MN 55330
(612) 327-5349
Mailing address
21216 VERNON ST NW, ELK RIVER, MN 55330-8837
(612) 327-5349
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
124770
MN
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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