Individual
BRIAN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
147 2ND ST NW, ORTONVILLE, MN 56278-1408
(320) 839-6102
Mailing address
147 2ND ST NW, ORTONVILLE, MN 56278-1408
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118830
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
559135100
—
MN
Enumeration date
04/22/2008
Last updated
04/22/2008
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