NPI 1003402017

Carl Peterson, PHARMD

Practitioner Pharmacist Bozeman, MT

Practice location

Address: 200 S 23rd Ave, Bozeman, MT 59718-3965
Phone: (406) 586-4785

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence PHA-PHA-LIC-73448 (MT)

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Registry record

NPI: 1003402017
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Dec 2020
Record last updated: 14 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.