DR. Eliza S. Petersen, AUD, CCCA

NPI #1083750996 in Driggs, Idaho

Provider Information

NPI Number: 1083750996
Entity Type: Individual
Name: DR. Eliza S. Petersen, AUD, CCCA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Audiologist
Credential: AUD, CCCA
Enumeration Date: Jan 29, 2007
Last Updated: Apr 19, 2023

Practice Location

Address: 2740 SHADOWMOON LN STE 417
City: Driggs
State: Idaho
ZIP Code: 83422-5083
Phone: (307) 745-5587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Audiologist	231H00000X	Primary

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