Individual
COLE DARRELL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 BURLINGTON ST SE, MANDAN, ND 58554-4281
(701) 667-1843
Mailing address
3213 43RD AVE NE, BISMARCK, ND 58503-8087
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6430
ND
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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