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General NPI Number Information
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NPI Number | 1396770830
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Entity Type | Individual
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Provider Name | ROSEMARY LOUISE ROSDAHL RPH
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 204 LEWIS AVE S SUITE 101
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City | WATERTOWN
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State | MN
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Zip | 55388-4500
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Country | US
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Telephone | 952-955-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 204 LEWIS AVE S SUITE 101
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City | WATERTOWN
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State | MN
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Zip | 55388-4500
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Country | US
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Telephone | 952-955-2153
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 113854
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License Number State | MN
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