Individual
ALEX YANG PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 23RD AVE E, WEST FARGO, ND 58078-7804
(701) 281-2222
Mailing address
750 23RD AVE E, WEST FARGO, ND 58078-7804
(701) 281-2222
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6067
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730421256
—
ND
Enumeration date
07/13/2018
Last updated
07/13/2018
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