Provider Demographics
NPI:1790383750
Name:HARLOW, MICHAEL CURTIS (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CURTIS
Last Name:HARLOW
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 RYANS RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-1721
Mailing Address - Country:US
Mailing Address - Phone:507-376-4080
Mailing Address - Fax:507-376-6524
Practice Address - Street 1:1055 RYANS RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-1721
Practice Address - Country:US
Practice Address - Phone:507-376-4080
Practice Address - Fax:507-376-6524
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist