Individual
DR. STEPHEN PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
555 S 70TH ST, LINCOLN, NE 68510-2462
(402) 219-7143
Mailing address
474 GLENDENNING PL, WAUKEGAN, IL 60087-5138
(847) 337-8701
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051298835
IL
183500000X
Pharmacist
15043
NE
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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