Individual
DR. IAN PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
315 W MULBERRY STE A, PILOT KNOB, MO 63663-7883
(573) 546-0602
(573) 546-0624
Mailing address
315 W MULBERRY STE A, PILOT KNOB, MO 63663-7883
(573) 546-0602
(573) 546-0624
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2022019197
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2019
Last updated
11/17/2022
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