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1295730661
PHILLIP H PETERSEN
OROFINO, ID
NPI
1295730661
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M5405)
Enumeration Date
2005-06-14
Last Update Date
2017-12-19
Business Address
PHILLIP H PETERSEN MD
301 CEDAR ST
OROFINO, ID 83544-9029
Phone number: 208-476-4555
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Mailing Address
PHILLIP H PETERSEN MD
301 CEDAR ST
OROFINO, ID 83544-9029
Phone number: 208-476-4555
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