Provider Demographics
NPI:1710286216
Name:SELZLER, CAROL M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:M
Last Name:SELZLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:ND
Mailing Address - Zip Code:58341-1520
Mailing Address - Country:US
Mailing Address - Phone:701-324-2295
Mailing Address - Fax:701-324-2295
Practice Address - Street 1:722 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:ND
Practice Address - Zip Code:58341-1520
Practice Address - Country:US
Practice Address - Phone:701-324-2295
Practice Address - Fax:701-324-2295
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist