Individual
MICHELLE L PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
735 SPRUCE ST, MYRTLE POINT, OR 97458-1154
(541) 572-5010
(541) 572-5507
Mailing address
735 SPRUCE ST, MYRTLE POINT, OR 97458-1154
(541) 572-5010
(541) 572-5507
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0010057
OR
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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