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1316030638
STACY L PETERSON
WICHITA, KS
NPI
1316030638
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: KS 0419242)
Enumeration Date
2006-09-30
Last Update Date
2007-07-08
Business Address
Dr. STACY L PETERSON m.d.
818 N EMPORIA ST SUITE 305
WICHITA, KS 67214-3729
Phone number: 316-265-1441
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Mailing Address
Dr. STACY L PETERSON m.d.
818 N EMPORIA ST SUITE 305
WICHITA, KS 67214-3729
Phone number: 316-265-1441
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