Individual
JACOB JOHN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3510
Mailing address
4328 PADDINGTON DR, CEDAR FALLS, IA 50613-8917
(319) 830-7471
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22766
IA
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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