Organization
KEVIN C PETERSON OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN C PETERSON (PRESIDENT)
(770) 664-5580
Entity
Organization
Contact information
Practice address
1845 LOCKEWAY DR, SUITE 401, ALPHARETTA, GA 30004-5936
(770) 664-5580
Mailing address
1845 LOCKEWAY DR, SUITE 401, ALPHARETTA, GA 30004-5936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1697
GA
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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