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Individual

DR. RYAN PAUL PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1553 W 9000 S, WEST JORDAN, UT 84088-9219
(801) 563-0300
(801) 565-4690
Mailing address
2685 S RAINBOW BLVD, SUITE 112, LAS VEGAS, NV 89146-5182
(801) 563-0300
(801) 565-4690

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5683991-1204
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5290622002001
UT
Enumeration date
10/04/2005
Last updated
10/29/2007
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