Brayden Petersen, OD

NPI #1932767753 in Sandpoint, Idaho

Provider Information

NPI Number: 1932767753
Entity Type: Individual
Name: Brayden Petersen, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jun 5, 2019
Last Updated: Aug 8, 2019

Practice Location

Address: 307 S 1ST AVE
City: Sandpoint
State: Idaho
ZIP Code: 83864-1201
Phone: (208) 263-8501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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