Individual
RICHARD NICHOLAS PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1705 E HANNA RD, ELOY, AZ 85131-9612
(520) 464-3067
Mailing address
1932 S FALCON DR, GILBERT, AZ 85295-5869
(480) 734-6261
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4680
AZ
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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