LACY PETERSEN

SALT LAKE CITY, UT
NPI1669634465
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: AZ  3646)
Enumeration Date2008-07-02
Last Update Date2008-07-02
Business Address
-- LACY PETERSEN
1952 E 7000 S
SALT LAKE CITY, UT 84121-6877
Phone number: 801-942-3311
Mailing Address
-- LACY PETERSEN
PO BOX 711185
SALT LAKE CITY, UT 84171-1185
Phone number: 801-942-3311