Individual
LEON ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TECHNICIAN-ATTENDANT
Contact information
Practice address
3316 E NUTMEG ST, SALT LAKE CITY, UT 84121-4310
(801) 243-8837
Mailing address
3316 E NUTMEG ST, SALT LAKE CITY, UT 84121-4310
(801) 243-8837
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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