Individual
DR. CHARLES JOHN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
308 HARVARD ST SE, MINNEAPOLIS, MN 55455-0343
(612) 626-5158
Mailing address
2316 FREMONT AVE S # 2, MINNEAPOLIS, MN 55405-2645
(612) 865-7796
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/01/2011
Last updated
05/01/2011
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