Individual
TRISTAN PHILIP PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERTIFIED SURGICAL T
Contact information
Practice address
5200 HUMMINGBIRD RD, SUITE 100, WAUSAU, WI 54401-6312
(715) 359-6442
(715) 393-0390
Mailing address
5200 HUMMINGBIRD RD., SUITE 100, WAUSAU, WI 54401-6312
(715) 359-6442
(715) 393-0390
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
167761
WI
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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