Individual
DR. KENT H PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1550 N MAIN ST, LOGAN, UT 84341-1918
(435) 753-0990
Mailing address
94 N 100 W, BRIGHAM CITY, UT 84302-2104
(801) 390-7254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4771034-1701
UT
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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