TIMOTHY LOU PETERSEN

LA CROSSE, WI
NPI1275030892
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: WI  83542-30)
Enumeration Date2018-04-10
Last Update Date2018-04-10
Business Address
TIMOTHY LOU PETERSEN RN
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-775-3969
Mailing Address
TIMOTHY LOU PETERSEN RN
GUNDERSEN HEALTH SYSTEM 1836 SOUTH AVENUE
LA CROSSE, WI 54601
Phone number: 608-775-3969