Organization
ROGER L PETERSEN OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER LESLIE PETERSEN OD (OWNER)
(660) 584-2956
Entity
Organization
Contact information
Practice address
1817 N MAIN ST, HIGGINSVILLE, MO 64037-1524
(660) 584-2956
(660) 584-3956
Mailing address
1817 N MAIN ST, HIGGINSVILLE, MO 64037-1524
(660) 584-2956
(660) 584-3956
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2272
MO
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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