Individual
DR. JOHN M PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
72 BARRE ST, MONTPELIER, VT 05602-3508
(802) 229-9418
(802) 229-5619
Mailing address
72 BARRE ST, MONTPELIER, VT 05602-3508
(802) 229-9418
(802) 229-5619
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
032-0000291
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006153
—
VT
01
—
6153
BC/BS
VT
Enumeration date
10/23/2006
Last updated
07/08/2007
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