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General NPI Number Information
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NPI Number | 1275767832
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Entity Type | Individual
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Provider Name | DOREEN MARIE WUEBKERS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 1502 LONDON ROAD SUITE 101
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City | DULUTH
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State | MN
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Zip | 55812
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Country | US
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Telephone | 218-733-1110
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Fax | 218-733-1112
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Provider Business Mailing Address
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Address Line | 1502 LONDON ROAD SUITE 101
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City | DULUTH
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State | MN
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Zip | 55812
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Country | US
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Telephone | 218-733-1110
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Fax | 218-733-1112
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 706909
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License Number State | MN
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