Individual
ELLEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2809 100TH ST, URBANDALE, IA 50322-3860
(515) 252-7688
Mailing address
1609 W PRAIRIE WOOD CT, POLK CITY, IA 50226-1164
(515) 984-9267
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16769
IA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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