Individual
DR. STEPHEN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1157 N 300 W, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-1200
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
001250
IA
Other
Enumeration date
06/16/2005
Last updated
12/06/2013
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