NPI 1164962213
Mitchell Petersen
Practice location
- Address
- 550 Vandalia St 175, Saint Paul, MN 55114-1833
- Phone
- (651) 313-6733
- Mailing address
- 4251 Sunrise Rd, Eagan, MN 55122-2246
Registered specialties
Pharmacy Technician
Primary
Registry record
- NPI
- 1164962213
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Mar 2017
- Record last updated
- 7 Mar 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.