Individual
DR. LISA MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1626 TUTTLE ST STE 1, BARABOO, WI 53913-1501
(608) 356-2020
(608) 355-7055
Mailing address
1626 TUTTLE ST STE 1, BARABOO, WI 53913-1501
(608) 356-2020
(608) 355-7055
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3215-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881988244
—
WI
Enumeration date
06/02/2011
Last updated
11/11/2020
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