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Search › Nebraska › 333600000X

Michael Peterson

NPI 1134790090 · on the registry since 2021 · sole proprietor

Practice

Address
718 4th St
Gothenburg, NE 69138
Phone
(308) 537-2048
Fax
(308) 537-2231
Organisation at this address
Peterson'S Supermarket, Inc
Shopko Stores Operating Co Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
333600000X
333600000X
Licence states on file
NE
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-07-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nebraska