Individual
MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMR
Contact information
Practice address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Mailing address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12940-40
WI
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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