Individual
KENT LEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
919 12TH PL, SUITE 10, PRESCOTT, AZ 86305-1433
(928) 776-0770
(928) 776-8991
Mailing address
1206 ROLLING HILLS CIR, PRESCOTT, AZ 86303-6485
(928) 710-0770
(928) 445-3802
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0261
AZ
Other
Enumeration date
04/13/2007
Last updated
04/07/2017
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