Individual
WES HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6025 SHENANDOAH LN N, PLYMOUTH, MN 55446-4557
(763) 252-1300
(763) 252-1306
Mailing address
6025 SHENANDOAH LN N, PLYMOUTH, MN 55446-4557
(763) 252-1300
(763) 252-1306
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
114242
MN
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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