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Organization

RYAN PETERSON O.D., INC.

Active
Other names
FAMILY FOCUSED EYECARE
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RYAN KENT PETERSON O.D. (OWNER)
(702) 299-6200
Entity
Organization

Contact information

Practice address
2208 S RAINBOW BLVD, LAS VEGAS, NV 89146-2976
(702) 876-0320
(702) 876-3095
Mailing address
2208 S RAINBOW BLVD, LAS VEGAS, NV 89146-2976
(702) 876-0320
(702) 876-3095

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
532
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100506817
NV
05
100508598
NV
Enumeration date
07/17/2006
Last updated
02/10/2009
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