Individual
BOTROS HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
2420 DAWS DR, APT D, BOZEMAN, MT 59718-6979
(508) 250-9763
Mailing address
2420 DAWS DR, APT D, BOZEMAN, MT 59718-6979
(508) 250-9763
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42802
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H500-069-77-201-0
FLORIDA DRIVER LICENSE
FL
Enumeration date
03/17/2017
Last updated
03/17/2017
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