Individual
DANIEL ALLEN TELLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
24760 HOSPITAL RD, RED LAKE, MN 56671
(218) 679-3912
Mailing address
24760 HOSPITAL RD, RED, MN 56671
(218) 679-3912
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126507
MN
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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