Peterson, Richard
Peterson, Richard is an sole proprietor health care provider with primary practice located at 601 N Briarcliff Dr , Appleton WI 54915-2959. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, which is considered as his primary health care specialty. Peterson, Richard can be contacted via phone (920) 739-4466.Contact Information
Primary practice address
601 N Briarcliff Dr
Appleton WI 54915-2959
Phone: (920) 739-4466
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X | 1320-024 | Wisconsin |
Profile Details
| NPI number | 1720246036 |
|---|---|
| LBN Legal business name | Peterson, Richard |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2008 |
| Last updated | May 23rd, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720246036 | NPPES |
| Wisconsin | MEDICAID | 40070600 |
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