Individual
MR. LANCE DAMON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISSTANT
Contact information
Practice address
150 YORK ST, STOUGHTON, MA 02072-1829
(339) 237-2629
Mailing address
50 VICTORIA RD, QUINCY, MA 02169-2433
(617) 328-8999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA291
MA
Other
Enumeration date
11/19/2007
Last updated
03/25/2019
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