KENNETH R PETERSEN

LACEY, WA
NPI1972879401
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: WA  ph00019664)
Enumeration Date2012-03-29
Last Update Date2012-03-29
Business Address
Mr. KENNETH R PETERSEN RPh
5500 MARTIN WAY E
LACEY, WA 98516-6326
Phone number: 360-456-4057
Mailing Address
Mr. KENNETH R PETERSEN RPh
5500 MARTIN WAY S.E.
LACEY, WA 98516
Phone number:
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