Provider Demographics
NPI:1902192735
Name:SEUNTJENS, RODNEY JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:JAMES
Last Name:SEUNTJENS
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 1:215 BALSAM ST N
Mailing Address - Street 2:T-1303
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-5814
Mailing Address - Country:US
Mailing Address - Phone:763-689-3687
Mailing Address - Fax:
Practice Address - Street 1:215 BALSAM ST N
Practice Address - Street 2:T-1303
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-5814
Practice Address - Country:US
Practice Address - Phone:763-689-3687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist