Organization
RED LEDGES DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARREN ALBERT PETERERSON DO (OWNER)
(435) 703-9296
Entity
Organization
Contact information
Practice address
1449 N 1400 W STE 22, ST GEORGE, UT 84770-5237
(435) 703-9296
Mailing address
1449 N 1400 W STE 22, ST GEORGE, UT 84770-5237
(435) 703-9296
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
179077-1204
UT
Other
Enumeration date
10/10/2017
Last updated
03/08/2018
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