Individual
SARA VANDE WALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
8400 NORMANDALE LAKE BLVD STE 700, BLOOMINGTON, MN 55437-3810
(612) 777-6511
Mailing address
8400 NORMANDALE LAKE BLVD STE 700, BLOOMINGTON, MN 55437-3810
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123507
MN
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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