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Individual
NATHANAEL JOSEPH PEATY
Active
Individual
NATHANAEL JOSEPH PEATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14517-040
WI
183500000X
Pharmacist
17907
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14517-040
PHARMACIST
WI
01
—
17907
PHARMACIST
NC
Enumeration date
11/17/2006
Last updated
07/08/2007
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