Individual
LISA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 CALUMET AVE SW, DE SMET, SD 57231-2161
(605) 854-9033
(605) 854-9114
Mailing address
307 4TH ST SW, DE SMET, SD 57231-2230
(605) 854-9033
(605) 854-9114
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5091
SD
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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