NPI 1013574441

Jacob Thomas Lilletvedt, PHARMACIST

Practitioner Pharmacist Miles City, MT

Practice location

Address: 519 S Haynes Ave, Miles City, MT 59301-4768
Phone: (406) 232-4627
Mailing address: 315 Charles St APT 28, Miles City, MT 59301-4158

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence PHA-PHA-LIC-55429 (MT)

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Registry record

NPI: 1013574441
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 May 2019
Record last updated: 21 May 2019

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.