MR. Raymond Keith Vellenga, RPH

NPI #1356614119 in Forest Lake, Minnesota

Provider Information

NPI Number: 1356614119
Entity Type: Individual
Name: MR. Raymond Keith Vellenga, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Feb 9, 2012
Last Updated: Feb 9, 2012

Practice Location

Address: 7617 172ND AVE NE
City: Forest Lake
State: Minnesota
ZIP Code: 55025-8873
Phone: (651) 464-5274

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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