Individual
MATTHEW SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1213 15TH AVE W, WILLISTON, ND 58801-3800
(701) 774-7477
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7433
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH5669
ND
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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