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General NPI Number Information
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NPI Number | 1770174906
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Entity Type | Individual
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Provider Name | SARA JO SEEMAN
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Gender | Female
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Dates
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Enumeration Date | 01/30/2021
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Last Update Date | 01/30/2021
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Provider Practice Location Address
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Address Line | 14125 LOUISIANA AVE S UNIT 3108
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City | SAVAGE
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State | MN
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Zip | 55378-5674
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Country | US
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Telephone | 952-237-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 14125 LOUISIANA AVE S UNIT 3108
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City | SAVAGE
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State | MN
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Zip | 55378-5674
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Country | US
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Telephone | 952-237-7935
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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 | 116365
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License Number State | MN
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