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Individual

DAVID CLYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
21495 141ST AVE N, ROGERS, MN 55374-4583
(763) 428-5802
(763) 428-3057
Mailing address
21495 141ST AVE N, ROGERS, MN 55374-4583
(763) 428-5802
(763) 428-3057

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051-032107
IL
183500000X
Pharmacist
Primary
1163218
MN

Other

Enumeration date
10/19/2011
Last updated
10/19/2011
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