Individual
GARTH PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11207 N 133RD EAST AVE, OWASSO, OK 74055-5669
(918) 257-2147
Mailing address
11207 N 133RD EAST AVE, OWASSO, OK 74055-5669
(918) 257-2147
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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