Individual
JOHN D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
24106 STATE ROAD 35 70, SIREN, WI 54872-8006
(715) 349-2221
(715) 349-7350
Mailing address
PO BOX 503, SIREN, WI 54872-0503
(715) 349-2221
(715) 349-7350
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16207-40
WI
Other
Enumeration date
04/30/2012
Last updated
10/11/2019
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