Individual
DR. SCOTT TREVOR PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5799
(208) 814-2500
Mailing address
288 ADAMS ST APT B, TWIN FALLS, ID 83301-5108
(208) 814-2500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5781411
ID
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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