Individual
CARL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 S 23RD AVE, BOZEMAN, MT 59718-3965
(406) 586-4785
Mailing address
200 S 23RD AVE, BOZEMAN, MT 59718-3965
(406) 586-4785
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA-PHA-LIC-73448
MT
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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