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Kelly Marie Dethloff, PharmD.

Pharmacist in Virginia, MN. Individual provider (NPI-1).

NPI number1982942025
StatusActive
Last updated in NPPESJan 24, 2013

Details

NPI
1982942025
Entity type
Individual (NPI-1)
Name
Kelly Marie Dethloff
Credential
PharmD.
Sex
Female
Sole proprietor
No
Enumeration date
Jan 24, 2013
Last updated
Jan 24, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist118343MNYes

Other names

  • Kelly Marie Urick (Former Name)

Practice location

901 9th St N
Virginia, MN 55792-2325

Phone 218-749-9441 · Fax 218-749-9565

Mailing address

901 9th St N
Virginia, MN 55792-2325

Phone 218-749-9441 · Fax 218-749-9565

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