Individual
REBECCA PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
770 S 400 E APT 50, BRIGHAM CITY, UT 84302-3351
(435) 720-3840
Mailing address
770 S 400 E APT 50, BRIGHAM CITY, UT 84302-3351
(435) 720-3840
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5911503-1701
UT
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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