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Individual

DR. MARK R PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-5285
Mailing address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-5285

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102203109
VA

Other

Enumeration date
07/10/2010
Last updated
05/01/2018
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