Individual
MR. MICHAEL LEE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
(715) 717-1000
Mailing address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11357-40
WI
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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