Individual
MICHELLE GERISE-KOOPMEINERS ETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 255-6465
(320) 255-6360
Mailing address
213 MUSTANG LN, MELROSE, MN 56352-1388
(320) 256-5166
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115240-7
MN
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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