Individual
DR. GARY PHILLIP PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2404 S PERRYVILLE RD, ROCKFORD, IL 61108-8231
(815) 332-3256
(815) 332-4180
Mailing address
2404 S PERRYVILLE RD, ROCKFORD, IL 61108-8231
(815) 332-3256
(815) 332-4180
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.290809
IL
Other
Enumeration date
09/03/2011
Last updated
09/03/2011
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