Individual
KALEB BARSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6140
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BAR-91-3118
DRIVERS LICENSE
ND
Enumeration date
09/04/2019
Last updated
09/04/2019
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