Individual
BLAINE ALAN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
(417) 732-1529
Mailing address
PO BOX 397, NIXA, MO 65714-0397
(417) 893-3900
(417) 893-3909
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2016023705
MO
Other
Enumeration date
07/06/2016
Last updated
10/13/2023
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