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1144885575
MICHAEL PETERSON
ROSEBURG, OR
NPI
1144885575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA197860)
Enumeration Date
2019-05-01
Last Update Date
2020-10-01
Business Address
MICHAEL PETERSON PA-C
2801 NW MERCY DR STE 300
ROSEBURG, OR 97471-2348
Phone number: 541-677-1555
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Mailing Address
MICHAEL PETERSON PA-C
201 NW MEDICAL LOOP STE 190
ROSEBURG, OR 97471-8835
Phone number: 541-677-4319
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