Individual
JOHN THEODORE SAMUELSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
118 W. 5TH ST., BOX 399, STARBUCK, MN 56381-0399
(320) 239-2246
(320) 239-2296
Mailing address
710 MEADOW LN, STARBUCK, MN 56381-4504
(320) 239-4361
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111321-3
MN
Other
Enumeration date
06/17/2005
Last updated
07/08/2007
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