Individual
CLARISSA L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
299 E 900 S STE 101, PROVO, UT 84606-6107
(801) 374-9660
Mailing address
589 SOUTH STATE STREET, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7457934-1206
UT
Other
Enumeration date
09/14/2009
Last updated
05/20/2024
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