Provider Demographics
NPI:1154533545
Name:CHATRIAND, KENNETH (PHARMD)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:CHATRIAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 EDDY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59812-1851
Mailing Address - Country:US
Mailing Address - Phone:406-243-5167
Mailing Address - Fax:406-243-6185
Practice Address - Street 1:634 EDDY AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59812-1851
Practice Address - Country:US
Practice Address - Phone:406-243-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist