Organization
PETERSON PERFORMANCE PRODUCTS, INC.
Active
Other names
Foot Fitness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELODY ANNE PETERSON C. PED., LMT (CO-OWNER, VICE PRESIDENT, SEC/TREAS)
(541) 617-1505
Entity
Organization
Contact information
Practice address
2200 NE NEFF RD, SUITE 307, BEND, OR 97701-4283
(541) 617-1505
(541) 617-1527
Mailing address
2200 NE NEFF RD, SUITE 307, BEND, OR 97701-4283
(541) 617-1505
(541) 617-1527
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/08/2006
Last updated
08/22/2020
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