Individual
MR. JAMES ROBERT PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4000 UNIVERSITY AVE, WATERLOO, IA 50701-5640
(319) 236-1786
(319) 236-0074
Mailing address
1109 BOBBI LN, WATERLOO, IA 50701-3230
(319) 236-1786
(319) 236-0074
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14811
IA
183500000X
Pharmacist
IA14811
IA
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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