Individual
DANIEL WIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1550 BLAKE AVE, ALBERT LEA, MN 56007-6304
(507) 377-0668
Mailing address
1550 BLAKE AVE, ALBERT LEA, MN 56007-6304
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123533
MN
183500000X
Pharmacist
23144
IA
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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