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Individual

DR. SUSAN ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
4005 VINEWOOD LANE N, WALGREENS 02767, PLYMOUTH, MN 55442
(763) 553-9731
(763) 553-9144
Mailing address
4005 VINEWOOD LANE N, WALGREENS 02767, PLYMOUTH, MN 55442
(763) 553-9731
(763) 553-9144

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121755
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121755
MN BOARD OF PHARMACY LICENSE NUMBER
MN
Enumeration date
02/24/2015
Last updated
02/24/2015
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