Organization
BRIAN R PETERSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN R PETERSON MD (SOLE PROPRIETOR)
(801) 566-8304
Entity
Organization
Contact information
Practice address
3584 W 9000 S, SUITE 311, WEST JORDAN, UT 84088-4775
(801) 566-8304
(801) 566-8330
Mailing address
3584 W 9000 S, SUITE 311, WEST JORDAN, UT 84088-4775
(801) 566-8304
(801) 566-8330
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3139741205
UT
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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