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Individual

TANNER BOUTAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
Mailing address
708 3RD AVE NE, DILWORTH, MN 56529-2110
(218) 303-6816

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6678
ND

Other

Enumeration date
07/24/2025
Last updated
07/24/2025
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