Jordon Wild

NPI #1215283049 in Bloomington, Minnesota

Provider Information

NPI Number: 1215283049
Entity Type: Individual
Name: Jordon Wild
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Jul 30, 2012
Last Updated: Jul 30, 2012

Practice Location

Address: 9651 WYOMING TER S
City: Bloomington
State: Minnesota
ZIP Code: 55438-1606
Phone: (612) 803-8537

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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