Individual
DAVID MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1200 W GOLD ST, BUTTE, MT 59701-2110
(406) 494-1075
Mailing address
1200 W GOLD ST, BUTTE, MT 59701-2110
(406) 494-1075
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA-PHA-2883
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHA-PHA-LIC-2883
PHARMACY LIC #
MT
Enumeration date
09/18/2013
Last updated
09/18/2013
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