Provider Demographics
NPI:1831389634
Name:DETERMAN, CHRISTOPHER DAVID (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:DETERMAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 2ND AVE NE
Mailing Address - Street 2:COBORN'S PHARMACY
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345
Mailing Address - Country:US
Mailing Address - Phone:320-632-2380
Mailing Address - Fax:320-632-3079
Practice Address - Street 1:1105 2ND AVE NE
Practice Address - Street 2:COBORN'S PHARMACY
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345
Practice Address - Country:US
Practice Address - Phone:320-632-2380
Practice Address - Fax:320-632-3079
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist