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Individual

MR. DAVID JOHN LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
17 DIVISION ST, WAITE PARK, MN 56387-1349
(320) 203-1035
Mailing address
6483 36TH AVE SE, SAINT CLOUD, MN 56304-9409
(320) 656-5830

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112825
MN

Other

Enumeration date
12/24/2011
Last updated
12/24/2011
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