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General NPI Number Information
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NPI Number | 1407454457
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Entity Type | Individual
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Provider Name | WES ETHAN STETTNER PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 3001 E HIGHWAY 7
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City | MONTEVIDEO
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State | MN
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Zip | 56265-4556
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Country | US
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Telephone | 320-269-5496
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Fax | 320-269-8575
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Provider Business Mailing Address
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Address Line | 3025 COUNTY ROAD 15 SW
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City | MONTEVIDEO
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State | MN
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Zip | 56265-4006
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Country | US
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Telephone | 218-770-3966
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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 | 120808
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License Number State | MN
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