Individual
DR. ETHAN KLUTENKAMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
3933 S BROADWAY, SAINT LOUIS, MO 63118-4601
(314) 865-7080
Mailing address
5624 PERNOD AVE, SAINT LOUIS, MO 63139-1506
(636) 284-6712
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2018032020
MO
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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