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Individual

JOHN CLAYTON PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Contact information

Practice address
700 DIVISION ST S, NORTHFIELD, MN 55057-2427
(507) 645-4455
(507) 645-6912
Mailing address
17719 LANDMARK CT, LAKEVILLE, MN 55044-5229
(952) 898-0637
(952) 898-0637

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
110841
MN

Other

Enumeration date
02/27/2012
Last updated
02/27/2012
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