Individual
LYNN LEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
14177 ASH BLVD, BECKER, MN 55308-8945
(763) 360-0858
Mailing address
10961 CLUB WEST PKWY, BLAINE, MN 55449-5866
(763) 528-2975
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113656
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113656
MN PHARMACIST LICENSE
MN
Enumeration date
03/04/2013
Last updated
03/04/2013
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