Individual
DAVID WILLIAM PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
108 W WALL ST, EAGLE RIVER, WI 54521-9811
(715) 479-1069
(715) 479-1370
Mailing address
108 W WALL ST, EAGLE RIVER, WI 54521-9811
(715) 479-1069
(715) 479-1370
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8846-040
WI
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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