Most Relevant Information
Provider Data
| NPI Number: | 1003184771 |
| Provider Name: | SHELLEY GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 116453 |
Most Important Dates
| Enumeration Date: | 12/08/2011 |
| Last Updated: | 12/08/2011 |
Provider Practice Location
600 COUNTY ROAD 10 NE
BLAINE
MN
554342329
Practice Location Phone/Fax
| Phone: | 7637869081 |
| Fax: | 7637863122 |
Provider Mailing Location
600 COUNTY ROAD 10 NE
BLAINE
MN
554342329
Provider Mailing Phone/Fax
| Phone: | 7637869081 |
| Fax: | 7637863122 |