Individual
DR. GARRICK KEVIN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
141 S MIRAGE AVE, LINDSAY, CA 93247-2541
(559) 562-4963
(559) 562-1333
Mailing address
PO BOX 928, LINDSAY, CA 93247-0928
(559) 562-4963
(559) 562-1333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9157T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DS0091570
—
CA
Enumeration date
06/21/2006
Last updated
03/24/2016
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