Individual provider · NPI-1

Keats Bovard

Pharmacist · Mankato, MN

NPI number1992317929
StatusActive
Last updated in NPPESAug 20, 2020

Details

NPI
1992317929
Entity type
Individual (NPI-1)
Name
Keats Bovard
Sex
Male
Sole proprietor
No
Enumeration date
Aug 20, 2020
Certification date
Aug 20, 2020
Last updated
Aug 20, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist124719MNYes

Practice location

1270 Madison Ave
Mankato, MN 56001-5228

Phone 507-388-1315 · Fax 507-388-6369

Mailing address

1270 Madison Ave
Mankato, MN 56001-5228

Phone 507-388-1315 · Fax 507-388-6369

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