Petersen, Brayden

Petersen, Brayden is an individual health care provider with primary practice located at 307 S 1St Ave , Sandpoint ID 83864-1201. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Petersen, Brayden can be contacted via phone (208) 263-8501.

Contact Information

Primary practice address
307 S 1St Ave Sandpoint ID 83864-1201
Phone: (208) 263-8501
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD60970822 Washington
Eye and Vision Services Providers / Optometrist 152W00000X ODP100472 Idaho

Profile Details

NPI number 1932767753
LBN Legal business name Petersen, Brayden
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2019
Last updated Aug 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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