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Individual

SAMUEL PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2625 W NATIONAL AVE, MILWAUKEE, WI 53204-1068
(414) 383-4021
(414) 383-0428
Mailing address
2625 W NATIONAL AVE, MILWAUKEE, WI 53204-1068
(414) 383-4021
(414) 383-0428

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17341
WI

Other

Enumeration date
02/25/2020
Last updated
02/25/2020
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