Individual
MATHEW PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ABOC
Contact information
Practice address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 576-6433
(801) 576-5643
Mailing address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 576-6433
(801) 576-5643
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
08/06/2014
Last updated
12/08/2021
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