Individual
RYAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 N CENTER ST, DELTA, UT 84624-8430
(435) 864-3073
Mailing address
152 N 400 W, EPHRAIM, UT 84627-5549
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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