LUCAS ROBERT VANDERGON

PLYMOUTH, MN
NPI1710653001
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: MN  125352)
Enumeration Date2021-08-18
Last Update Date2021-08-18
Business Address
LUCAS ROBERT VANDERGON
3255 VICKSBURG LN N
PLYMOUTH, MN 55447-1317
Phone number: 763-253-8917
Mailing Address
LUCAS ROBERT VANDERGON
8822 SHADYVIEW LN N
MAPLE GROVE, MN 55311-1490
Phone number: 763-234-9730
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