Individual
MR. RICHARD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
216 MEMPHIS ST, BOGALUSA, LA 70427-3844
(985) 735-0160
(985) 735-0970
Mailing address
216 MEMPHIS ST, BOGALUSA, LA 70427-3844
(985) 735-0160
(985) 735-0970
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PSS-930
LA
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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