Individual
BERTRAND FONTEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1003 N US HIGHWAY 65, CARROLLTON, MO 64633-1972
(660) 542-1111
(660) 542-3051
Mailing address
1003 N US HIGHWAY 65, CARROLLTON, MO 64633-1972
(660) 542-1111
(660) 542-3051
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2018031227
MO
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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