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1194277749
ELISE ROSE LICHTENBERG PETERSON
SALT LAKE CITY, UT
NPI
1194277749
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Former Name
ELISE ROSE LICHTENBERG
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: UT 10143483-4201)
Enumeration Date
2016-10-31
Last Update Date
2020-03-24
Business Address
ELISE ROSE LICHTENBERG PETERSON MSOTR/L
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113-1103
Phone number: 801-662-1000
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Mailing Address
ELISE ROSE LICHTENBERG PETERSON MSOTR/L
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113-1103
Phone number:
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