Individual
MISS ALICE RUTH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
4545 E CHANDLER BLVD STE 104, PHOENIX, AZ 85048-7647
(480) 728-4400
(480) 728-4411
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2837
AZ
363AM0700X
Medical Physician Assistant
Primary
2837
AZ
Other
Enumeration date
12/13/2006
Last updated
12/11/2024
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