Chantra Prom, PHARMD

NPI #1992197107 in Bloomington, Minnesota

Provider Information

NPI Number: 1992197107
Entity Type: Individual
Name: Chantra Prom, PHARMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMD
Enumeration Date: Feb 25, 2015
Last Updated: Feb 25, 2015

Practice Location

Address: 7940 PENN AVE S
City: Bloomington
State: Minnesota
ZIP Code: 55431-1315
Phone: (952) 252-1154

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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