Organization
PETERSON PERFORMANCE PRODUCTS INC
Active
Other names
Peterson's Orthotic Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT WILLIAM PETERSON C. PED., C. O. (PRESIDENT)
(541) 647-1108
Entity
Organization
Contact information
Practice address
900 SE WILSON AVE, SUITE F, BEND, OR 97702-1416
(541) 647-1108
(541) 647-2162
Mailing address
900 SE WILSON AVE, SUITE F, BEND, OR 97702-1416
(541) 647-1108
(541) 647-2162
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
C15236
OR
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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