MR. William J Supalla, RPH

NPI #1760520373 in Fairmont, Minnesota

Provider Information

NPI Number: 1760520373
Entity Type: Individual
Name: MR. William J Supalla, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Feb 3, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 322 S STATE ST
Address 2: FIVE LAKES CENTRE
City: Fairmont
State: Minnesota
ZIP Code: 56031-4139
Phone: (507) 238-2797

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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