Individual
MR. RONNIE ANDY CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8949 UNIVERSITY AVE NE, BLAINE, MN 55434-8000
(763) 786-6820
Mailing address
1022 104TH LN NW, COON RAPIDS, MN 55433-4992
(763) 754-1717
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117760
MN
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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