Individual
SHANNON PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-3650
(319) 730-0636
Mailing address
324 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-3650
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19307
IA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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