Individual
BETHANY WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
301 PARK DR, OWATONNA, MN 55060-5639
(507) 451-1771
Mailing address
315 CENTER ST, MANKATO, MN 56001-3939
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121079
MN
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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