DR. Colter Jess Haderlie

NPI #1699143107 in Afton, Wyoming

Provider Information

NPI Number: 1699143107
Entity Type: Individual
Name: DR. Colter Jess Haderlie
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Sep 14, 2015
Last Updated: Sep 14, 2015

Practice Location

Address: 679 S WASHINGTON ST
City: Afton
State: Wyoming
ZIP Code: 83110-6000
Phone: (307) 885-9804

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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