Individual
JEFFREY R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
324 MAIN STREET, SAXONBURG, PA 16056
(724) 352-2433
(724) 352-8466
Mailing address
PO BOX 500, 324 MAIN STREET, SAXONBURG, PA 16056
(724) 352-2433
(724) 352-8466
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000391
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01939081
—
PA
Enumeration date
08/15/2006
Last updated
11/11/2008
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