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1023504412
CHRISTOPHER RUSSELL PETERSON
OCEANSIDE, CA
NPI
1023504412
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2018-07-09
Last Update Date
2018-07-09
Business Address
CHRISTOPHER RUSSELL PETERSON Idependent Duty Corp
909 ASH RD
OCEANSIDE, CA 92058-8664
Phone number: 818-404-4527
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Mailing Address
CHRISTOPHER RUSSELL PETERSON Idependent Duty Corp
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
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