Individual
CARTER HAVICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2400
Mailing address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19633
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19633
LICENSE
WI
Enumeration date
01/16/2019
Last updated
10/17/2022
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