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Organization

PAULA C. PETERSON, OD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. STACIA A DECKER (VP OF RETAIL)
(520) 327-6215
Entity
Organization

Contact information

Practice address
440 N ALVERNON WAY, TUCSON, AZ 85711-1958
(520) 881-2188
(520) 327-0368
Mailing address
440 N ALVERNON WAY, TUCSON, AZ 85711-1958
(520) 881-2188
(520) 327-0368

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0477
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
034421
AZ
Enumeration date
05/14/2010
Last updated
05/14/2010
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