Individual
MRS. BRANDY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.B.O.C., N.C.L.E.
Contact information
Practice address
18511 SOUTH RIVER RD,, THREE RIVERS, MI 49093
(734) 657-7543
Mailing address
18511 SOUTH RIVER RD,, THREE RIVERS, MI 49093
Taxonomy
Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
156379
MI
156FX1800X
Optician
Primary
156379
MI
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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