Individual
MR. ALLEN WAYNE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 ROBERT ST S, C/O CUB PHARMACY, W ST PAUL, MN 55118-3924
(651) 451-1113
(651) 451-9109
Mailing address
2001 ROBERT ST S, C/O CUB PHARMACY, W ST PAUL, MN 55118-3924
(651) 451-1113
(651) 451-9109
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
112856
MN
Other
Enumeration date
01/16/2007
Last updated
08/30/2007
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