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Individual

KENDALL R PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R. PH.

Contact information

Practice address
401 COUNTY ROAD 42 E, BURNSVILLE, MN 55306-5706
(952) 435-8145
(952) 435-5513
Mailing address
532 EASTWOOD CT, EAGAN, MN 55123-3067
(651) 688-2230

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116694-3
MN

Other

Enumeration date
07/21/2006
Last updated
07/08/2007
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