Individual
DR. SAMANTHA LEA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
401 2ND ST, IDA GROVE, IA 51445-1302
(712) 364-2120
Mailing address
401 2ND ST, IDA GROVE, IA 51445-1302
(712) 364-2120
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21459
IA
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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