Individual
BRADLEY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 WESTERN AVE NW, FARIBAULT, MN 55021-4504
(507) 332-0084
Mailing address
150 WESTERN AVE NW, FARIBAULT, MN 55021-4504
(507) 332-0084
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121886
MN
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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