Individual
MR. COREY REX PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2260 WRIGHTSBORO RD, AUGUSTA, GA 30904-4764
(706) 736-2273
(706) 736-7171
Mailing address
4478 SPARKLEBERRY CT, EVANS, GA 30809-4454
(706) 860-7362
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN168422
GA
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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