Individual
EDWARD A PETERS III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1002 N US 27, SAINT JOHNS, MI 48879-1129
(989) 224-3937
(989) 224-4999
Mailing address
1002 N US 27, SAINT JOHNS, MI 48879-1129
(989) 224-3937
(989) 224-4999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003069
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2937493
—
MI
Enumeration date
10/25/2005
Last updated
07/08/2007
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