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1720105901
SCOTT W PETERSON
WASILLA, AK
NPI
1720105901
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AK 246)
Enumeration Date
2007-03-23
Last Update Date
2007-07-09
Business Address
Mr. SCOTT W PETERSON PA
950 BOGARD RD SUITE 233
WASILLA, AK 99654-7105
Phone number: 907-352-2880
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Mailing Address
Mr. SCOTT W PETERSON PA
950 BOGARD RD SUITE 233
WASILLA, AK 99654-7105
Phone number: 907-352-2880
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