Most Relevant Information
Provider Data
| NPI Number: | 1003402017 |
| Provider Name: | CARL PETERSON PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PHA-PHA-LIC-73448 |
Most Important Dates
| Enumeration Date: | 12/14/2020 |
| Last Updated: | 12/14/2020 |
Provider Practice Location
200 S 23RD AVE
BOZEMAN
MT
597183965
Practice Location Phone/Fax
| Phone: | 4065864785 |
| Fax: |
Provider Mailing Location
200 S 23RD AVE
BOZEMAN
MT
597183965
Provider Mailing Phone/Fax
| Phone: | 4065864785 |
| Fax: |