Individual
SPENCER GIRARD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 776-6018
(928) 717-7596
Mailing address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 776-6018
(928) 717-7596
Taxonomy
Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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