DEREK PETERSEN

OGDEN, UT
NPI1104365113
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: UT  10232646-1206)
Enumeration Date2017-02-23
Last Update Date2017-02-23
Business Address
-- DEREK PETERSEN PA-C
2240 ADAMS AVE
OGDEN, UT 84401-1511
Phone number: 801-393-5355
Mailing Address
-- DEREK PETERSEN PA-C
2240 ADAMS AVE
OGDEN, UT 84401-1511
Phone number: 801-393-5355
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