Individual
ANGELA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1536 EGG HARBOR RD, STURGEON BAY, WI 54235-1257
(920) 746-0412
Mailing address
8827 COUNTY ROAD D, FORESTVILLE, WI 54213-9726
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17380-40
WI
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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