Individual
DANIEL BEN MOLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
125 W BROADWAY ST, BLAIR, WI 54616-9367
(608) 989-2919
(608) 989-2837
Mailing address
15520 GOLF RD, ETTRICK, WI 54627-7839
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9148040
WI
Other
Enumeration date
02/19/2007
Last updated
07/25/2007
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