Individual
DR. MEGAN R DETHLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Mailing address
1306 CHERRY ST, AURORA, NE 68818-3021
(308) 233-4847
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13421
NE
Other
Enumeration date
06/28/2010
Last updated
05/24/2011
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