Individual
DR. ROGER LESLIE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1817 MAIN ST, HIGGINSVILLE, MO 64037-1524
(660) 584-2956
(660) 584-3956
Mailing address
1817 MAIN ST, HIGGINSVILLE, MO 64037-1524
(660) 584-2956
(660) 584-3956
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2272
MO
Other
Enumeration date
06/12/2006
Last updated
10/29/2016
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