Individual
TORY R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1040 REED AVE, WYOMISSING, PA 19610-2029
(610) 898-7040
(610) 376-8239
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD432225
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101997515
—
PA
Enumeration date
05/18/2007
Last updated
11/18/2014
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