Organization
ANOVA DERMATOLOGY PC
Active
Other names
Aspen Cosmetic Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PETERSON MD (MD)
(801) 295-3095
Entity
Organization
Contact information
Practice address
425 MEDICAL DR. STE 220, BOUNTIFUL, UT 84010
(801) 295-3095
Mailing address
425 MEDICAL DR. STE 220, BOUNTIFUL, UT 84010
(801) 295-3095
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/11/2010
Last updated
08/30/2010
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