Roger L Petersen Od

NPI #1992829006 in Higginsville, Missouri

Provider Information

NPI Number: 1992829006
Entity Type: Organization
Organization Name: Roger L Petersen Od
Primary Specialty: Optometrist
Enumeration Date: Mar 16, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1817 N MAIN ST
City: Higginsville
State: Missouri
ZIP Code: 64037-1524
Phone: (660) 584-2956

Authorized Official

Name: DR. ROGER LESLIE PETERSEN, OD
Title: OWNER
Phone: (660) 584-2956

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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