Individual
JEN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2202 17TH ST, SPIRIT LAKE, IA 51360
(712) 336-4731
(800) 604-9151
Mailing address
PO BOX 303, SPIRIT LAKE, IA 51360-0303
(712) 336-4731
(800) 604-9151
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17899
IA
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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