Individual
TRENTON JAMES PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1068 E COUNTRY ESTATES LN, KANAB, UT 84741-3925
(356) 890-8884
Mailing address
PO BOX 1496, PAGE, AZ 86040
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019412
AZ
Other
Enumeration date
09/12/2012
Last updated
05/08/2024
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