Individual
DR. LELAND DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4032 BLACKHAWK RD, ROCK ISLAND, IL 61201-7064
(309) 786-9734
(309) 786-9790
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9540
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007274
IL
Other
Enumeration date
06/26/2007
Last updated
01/14/2014
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