Peterson, Maverick Lee
Peterson, Maverick Lee is an individual health care provider with primary practice located at 224 W D. L. Ingram Avenue, Bldg. 1408 , Cannon Afb NM 88103. He recently has only one registered license in Other Service Providers / Independent Duty Medical Technicians, which is considered as his primary health care specialty. Peterson, Maverick Lee can be contacted via phone (715) 817-6949.Contact Information
Primary practice address
224 W D. L. Ingram Avenue, Bldg. 1408
Cannon Afb NM 88103
Phone: (715) 817-6949
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Medical Technicians | 1710I1003X |
Profile Details
| NPI number | 1346028149 |
|---|---|
| LBN Legal business name | Peterson, Maverick Lee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2023 |
| Last updated | Feb 2nd, 2024 - about 10 months 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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