Individual
RICHARD CHARLES PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 MAPLE ST, ASHLAND, OR 97520-1514
(541) 482-2341
Mailing address
1624 E MAIN ST, MEDFORD, OR 97504-7514
(541) 531-4178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10010650
OR
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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