Individual
NICHOLAS ALLEN VAN PEURSEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1610 MONKS AVE, MANKATO, MN 56001-5173
(507) 625-1553
Mailing address
PO BOX 391, EAGLE LAKE, MN 56024-0391
(605) 553-6651
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124484
MN
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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